Monday, December 19, 2016

Christmas in the Fourth Quarter


Therefore the Lord himself will give you a sign: 
The virgin will conceive and give birth to a son, and will call him Immanuel. 
 Isaiah 7:14 (NIV)

I just had the wonderful experience of celebrating my 75th birthday…3/4 of a century!  For my grandchildren this is OLD!  I received a lot of wonderful hugs and kisses from them and best wishes from friends and family.  The question now before me is the Christmas celebration in the “Fourth Quarter”.   Is Christmas in the 4th quarter different then at other times in our lives?

My answer is “Yes”!  I have been particularly struck by the losses of friends and colleagues of my age that have been removed from my “contacts” and Christmas lists.   A part of my world is gone even though their stories remain.  That is what makes these celebrations so poignant.

One of the mantras in our family has been “finish strong”!  What I think that translates to in addressing “fourth quarter questions”  is the importance of continuing to live, to be surprised, to connect, to love and to cherish each other.  In the words of Paul Kalanitha, “Cease Not till Death”.  But our living will only have meaning if we connect to the larger stories in our lives.  For me, that is the Christmas pilgrimage where my story meets a larger story of faith.  It is the excitement and blessing of a Christmas birth story that leaves us with a big “AWE”!

Merry Christmas,

Marvin

Kalanithi, Paul (2016-01-12). When Breath Becomes Air (p. 118). Random House Publishing Group. Kindle Edition. 

Hage, ML Healing Doctors

Hage, ML A Royal Birth

Hage, M. L. (2011). Pilgrimage and Healing

Friday, December 2, 2016

Healing Doctors


Then the Lord God formed a man from the dust of the ground 
and breathed into his nostrils the breath of life, and the man became a living being.
Genesis 2:7 (NIV)

“With what strife and pains we come into the world we know not,
 but ’tis commonly no easy matter to get out of it.”
quote from Sir Thomas Browne, Religio Medici 


There are stories that are “awesome”…filled with the spiritual awe of a purpose driven life.  When Breath Becomes Air is one of those stories .  It is more than a memoir, but a call to all of us as we face the uncertainties of life.  We meet that call in the agent/patient, Paul Kalanithi, MD. and his wife, Lucy Kalanithi, MD.  The uniqueness of Paul Kalanithi’s report is his ability to tell two stories of a healing agent and patient at the same time.  His double vision is a gift to us all.

The take away for me is his understanding of the connectedness found in the doctor/patient dyad.  He is able to describe the interactions with clarity and care.  It is a conversation that will inspire you and bring you to tears.  Abraham Verghese’s report is “there was an honesty, a truth in the writing that took my breath away.” 

Another breathless moment is provided by Paul’s wife, Lucy, in an epilogue that underscores the context of love that was rediscovered and continues to sustain her.  It is going to take time for me to “catch my breath” and find the pearls that I missed with the first reading.

Marvin




References

Kalanithi, Paul (2016-01-12). When Breath Becomes Air (p. 53). Random House Publishing Group. Kindle Edition. 

Hage M.L. 2012. Hope. 



Tuesday, November 15, 2016

Is Healing Possible?

Montreat, North Carolina - November 1, 2016

 And the leaves of the tree are for the healing of the nations.
Revelation 22:2 (NIV)

There has been an amazing amount of “healing talk” this last week.  It has made me think about what I have written and whether or not healing is possible.  

First, I need to tell you about an amazing week of conversation, song and celebration.  Being  with “old” friends can bring you to a wonderful place like Montreat, North Carolina in the fall season.  That was followed by hearing young voices singing in concert and then celebration of Veteran’s day at two elementary schools with grandchildren.

There are two conclusions…The most important ingredient in healing is transformation (not information) and what these blogs/books have emphasized is that transformation is not where we are but where we are going.  We can face growing old, “storms of disease” and wars in ways that we could never imagine.  I experienced that reality this last and momentous week.

Marvin

References

Hage M.L.M.D. 2010. Healing Agents: Christian Perspectives. CreateSpace Independent Publishing Platform.

Hage M.L.M.D. 2012. Equipping Healing Agents: Sustaining Vocation. CreateSpace Independent Publishing Platform.

Hage M.L. 2012. God’s Grace.
Hage M.L. 2012. Techniques and Transformation. 



Wednesday, November 2, 2016

Healing Hospitals

“Guess it's not just all gizmo's and gadget’s.”
Pure Genius,  Pilot October 27, 2016

“Tell us please, what treatment in an emergency is administered by ear?…”
I met his gaze and I did not blink. "Words of comfort," I said to my father.” 
― Abraham Verghese, Cutting for Stone


This past week we were given a preview of the future of hospital care with the new CBS drama, “Pure Genius”.  The first show introduces the characters and the futuristic “Bunker Hill Hospital”.  This hospital is filled with “gizmos and gadgets” and with information management central to the drama. This hospital seems almost real! 

There are real organizations that recognize and promote “healing hospitals”.  It is what I see in hospitals wanting to connect with real people and real stories.  It is found in the efforts of “Schwartz Rounds” and the Duke Divinity School.  

Maybe the good news is we know the other dimensions of healing even when we are disappointed and frustrated by the technology.  The bad news is that we have not widely shared the real stories.

Marvin

References

Pure Genius Reviews


Hage, M. L. (2011). The Mystery of Healing.  

Wednesday, October 12, 2016

Healing Mission

For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.
Jeremiah 29:11 (NIV)

I have been reading a series of books about the direction of our lives as individuals and communities.  I know that seems like an odd choice for someone “on the back nine”.   My age group seems more likely to be focused on past accomplishments and writing their memoirs.  

My concern has been how will medicine and the church reconnect to the “Healing Mission”.  I saw the problem through the lens of my personal experiences.   What I found is that I am not alone in my concerns and the mission needs to be rediscovered by each generation.  Our job “on the back nine”, is to provide the tools to help the next generation discover their healing mission.  We need to design new healing mission solutions.

Maybe a better way forward would be to divide the “solutions” into smaller sections…personal, interpersonal and community.  What we can do as individuals, groups and communities are very different.  We all know that healing is a BIG mission that needs action.  The faith communities and healthcare share the mission of WELL BEING -BEING WELL.  Thanks for the new voices exploring these intersections.  Check out the work of Duke Divinity School.


Marvin

References

Burnett, B., & Evans, D. (2016). Designing Your Life: How to Build a Well-Lived, Joyful Life. Knopf.

Hage, M. L. (2015). Healing Work.

Hage, M. L. (2016). A Healing Curriculum.

Unexpected Intersections: Arts, Medicine, and Theology--Ray Barfield and Jeremy Begbie

Sunday, September 11, 2016

The Healing Challenge


“In the mid-twentieth century, the gap between science and religion grew even wider. Science had become god-like, and the public generally shared physicians’ confidence in its promise. But now, in this so-called postmodern world, society has grown skeptical of science and statistics, while medicine remains relentlessly positivistic, confident in its numbers and commitment to the material world, even when it attempts to address the spiritual.”
                                                                                            Jacalyn Duffin


Jacalyn Duffin faced the challenge to healing as an academic medical historian.  What she reports is a personal pilgrimage of searching and experience.  It is a wonderful and critical examination of individual and community healing stories that followed her medical review of a healing miracle.  

Healing stories require a “big” space for these complicated experiences.  We know that the spaces that have traditionally been found in our communities of faith are questioned.  Even the recent canonization of Mother Teresa has been challenged despite the powerful witness of her work. 

What is clear is that there needs to be a complementarity to the ways of science and faith.   People like  Rabbi Jonathan Sacks and Doctor Abraham Verghese are powerful voices of their respective vocations.   Added to that list is Professor Duffin who shows how specific communities carry their ancient stories of healing with them to new places in the world.  She has added to the dialogue between faith and science.

Thanks for sharing this complicated history of healing.

Marvin

References

Duffin, Jacalyn (2013-05-01). Medical Saints: Cosmas and Damian in a Postmodern World (p. 169). Oxford University Press. Kindle Edition. 

Hage, M. L. (2013). The Nature of Healing.

Hage, M. L. (2014). Hope Agents

Sacks, J. (2014). The Great Partnership: Science, Religion, and the Search for Meaning (Reprint ed.). Schocken.

Verghese, A. (2010). Cutting for Stone (1st ed.). Vintage Books.



Monday, September 5, 2016

Future Healing

Hope House, Mt. Pleasant, South Carolina
Mount Pleasant Presbyterian Church

For I know the plans I have for you,” 
declares the Lord, “plans to prosper you and not to harm you, 
plans to give you hope and a future.
Jeremiah 29:11 (NIV)

As patients we are concerned about the diagnosis but most afraid of the prognosis.  This is true for individuals as well as communities.  Our hopes seem to be found in either denial or illusions of control found in our technology.  

I just finished a critique of the culture of technology, Narratives of Technology, by J. M. van der Laan.  The focus of this book are the stories we tell about the technology.  What I learned is that we can easily over emphasize the benefits as well as the hazards of the control we seek.  

As physicians we are called to negotiate the diagnostic and prognostic uncertainties using our  technologies.  We change the statistics into stories.  The art is found in the creation of a narrative truth where trust can be found and fears of the future calmed.   Sometimes this happens during the care we provide.  More often the narratives happen in the quiet of places of faith like the “Hope House”.

Marvin


References

Hope House

van der Laan, J. M. (2016). Narratives of Technology (1st ed. 2016 ed.). Palgrave Macmillan.

Hage, M. L. (2012). Hope. 

Hage, M. L. (2014). The Limits of Healing?  

Hage, M. L. (2015). Telling the Story.

Wednesday, August 17, 2016

Healing Children


Helen DeVos Children’s Hospital
Grand Rapids, Michigan

“One trip through a children’s ward and if your faith isn’t shaken, 
you’re not the type who deserves any faith”
Peter De Vries (1959)

The people brought children to Jesus, hoping he might touch them. The disciples shooed them off. But Jesus was irate and let them know it: “Don’t push these children away. Don’t ever get between them and me. These children are at the very center of life in the kingdom. Mark this: Unless you accept God’s kingdom in the simplicity of a child, you’ll never get in.” Then, gathering the children up in his arms, he laid his hands of blessing on them
 Mark 10: 13-16 (MSG)


There are few challenges that test our faith as severely as sudden and serious illness in our children!   Peter DeVries identified our dilemma in his novel Blood of the Lamb.(1961)  What we pray for is that our children will be spared illness and suffering!  

Like the disciples, we miss seeing God’s kingdom.  We miss seeing the preparation and discipline of the many healing agents who have been called to be present in the emergencies.  We miss seeing God’s healing community.  We miss believing that we are all children of God.

What I have come to believe is that despite our anger and terror, God has been and is present in all the storms of life and he particularly cares for children!   Thanks be to God for his grace and blessing.

Poppy

References:

De Vries, P.. (2005). The Blood of the Lamb: A Novel (New edition ed.). University Of Chicago Press.  See foreword by Jeffrey Frank

Hage, J (2010) “The God that Weeps” Sermon delivered at Mt. Pleasant Presbyterian Church on 7/11/2010

Hage, M. L. (2012). God’s Grace.

Hage, M. L. (2015). Healing Grandparents.

Wednesday, July 13, 2016

Heart Healing



“That’s what we must pray for, each of us — A new heart.  Not a heart of stone, but a heart open to the fears and hopes and challenges of our fellow citizens.”
President Barack Obama - Dallas - July 12, 2016

I will give you a new heart and put a new spirit in you; 
I will remove from you your heart of stone and give you a heart of flesh.  
Ezekiel 36:26 (NIV)

The first healing books that I read were by Norman Cousins, The Anatomy of an Illness  and the companion Healing Heart.  I remember thinking how important it is to look for the other dimensions of disease of what I had only understood as pathophysiology.  

Yesterday, was a time to think anew about “a change of heart”, “a new heart”.  We need a new way forward.   The old responses have disappointed and have fallen short of our expectations.  We need to think and act differently if we expect reconciliation.  Where will be find this kind of heart healing?

The faith community is the one place that is equipped for this task.  We have become separated from this source of care and change.  Our “hearts” need to be reconnected with each other and the faith that sustains us.  The Lord promises this to his people who were broken and oppressed.  We believe that promise is still at work in the actions of people of faith.

Marvin

References

Cousins, N. (1983). Anatomy of an Illness. Bantam Doubleday Dell.
Cousins, N. (1984). Healing Heart. Avon Books (Mm).


Tuesday, June 21, 2016

Healing Hate




“Shoes on the Danube Bank”
Budapest, Hungary

"The composition titled 'Shoes on the Danube Bank' gives remembrance to the people ( mainly Budapest jews ) shot into the Danube during the time of the Arrow Cross terror. The sculptor created sixty pairs of period-appropriate shoes out of iron. The shoes are attached to the stone embankment, and behind them lies a 40 meter long, 70 cm high stone bench. At three points are cast iron signs, with the following text in Hungarian, English, and Hebrew: "To the memory of the victims shot into the Danube by Arrow Cross militiamen in 1944–45. Erected 16 April 2005."[

 “A new command I give you: Love one another. As I have loved you, so you must love one another.  By this everyone will know that you are my disciples, if you love one another.”
John 13:34-35 (NIV)

It happened on the same river that we were enjoying.  We were docked 100 meters from the “Shoes”.  We saw the remains of hate.  We have seen those remains again and again where hate becomes the command.  So besides erecting memorials what are we called to do!  The idea that remembering the tragedies will prevent them from reoccurring seems to be false given recent events.  Where is that balm in Gilead?  Can anger and hate be healed?  

Upon returning, I was informed that our church was reading Jim Wallis’s book, America’s Original Sin: Racism, White Privilege, and the Bridge to a New America.  There are multiple actions that are recommended in response.  The larger answer is that we must be the community of faith that witnesses to the larger truth of  being God’s children.  It is the Church’s witness of God’s response to the weeping of His children that brings healing and comfort to the grieving.

My personal answer is that I must confess my own quickness to hate, frustration and anger.  As Christians we are called to be bearers of the cross that represents our sins and ask again and  again for forgiveness.  The good news is that is where we meet Christ’s Love that promises a new heaven and a new earth.  

Thanks be to God for the gift of healing that first comes with a Love from above.

Marvin

References:



Wallis, J. (2016). America’s Original Sin: Racism, White Privilege, and the Bridge to a New America. Brazos Press.

Monday, June 6, 2016

The Search for Healing


Statue of Saints Cosmas (l) and Damian (r) with Christ (c) on the Charles Bridge
Prague, Czech Republic, 1709
The Patron Saints of Physicians

I just returned from a river cruise that ended in Prague.  We were taken to the famous Charles Bridge and during a brief stop, I found I was standing beneath a statue that speaks to the basis of healing across the centuries.  I almost missed it given all the beautiful architecture on a bright and sunny day in Prague.

What was impressive to me are the continued challenges to healing given the difficult history of the region. We had the opportunity to hear from a volunteer who aided refugees in Hungary.  We visited a school for the Roma people. There have been and are real challenges to the people of this region.  

The modern story of the search for healing also came unexpectedly from our guide, Peter Nagy who wrote, The Way Out.  It is ten short stories that address the modern dilemmas and meaning of life.  It was a wonderful way to hear the challenges from a young searcher.  It was a wonderful way to connect the dots of the past and present.

Marvin

References:

Hurst J. A modern Cosmas and Damian: Sir Roy Calne and Thomas Starzl receive the 2012 Lasker~Debakey Award. Journal of Clinical Investigation.  122(10):3378-82, 2012 Oct.



Thursday, May 19, 2016

Joy of Healing


Celebration at UNC School of Medicine Graduation

“…may I long experience the joy of healing those who seek my help.”
Hippocratic Oath

It is rare to find others who have traveled and share a similar vocational journey.  I found that person and journey in the book, The Finest Traditions of My Calling One Physician’s Search for the Renewal of Medicine, by Abraham Nussbaum, MD.   He has been on a big quest as his memoir recounts.

The book is full of big ideas and not the least of these is the “joy of healing” found in the last sentence of the Hippocratic oath.  This joy seems hard to find in the reality of current western medical practice.  As the photo demonstrates, there are exceptions even in the face of the reality.  

Will there be “joy” after 10 years of practice or at the end of their professional career?  There are certainly no guarantees, but I suggest that a positive response hinges on being able, like Abraham Nussbaum, to remember your calling and oaths.   These are the foundation for the “joy of healing”.

Marvin

References:

1. Screen shot from the UNC School of Medicine graduation on May 7, 2016

2. Nussbaum, Abraham M. (2016-03-22). The Finest Traditions of My Calling: One Physicians Search for the Renewal of Medicine. Yale University Press. Kindle Edition. 


Monday, May 9, 2016

A Healing Curriculum





What if you were given the opportunity to design an educational curriculum that had as its purpose the teaching and learning of healing?  What would you emphasize?  How would you do it?  Are there examples?  Does the healing goal exist under another name?

What I have found is this healing curriculum is identified by a variety of titles but only rarely is the word “healing” used.  The reasons are complicated particularly in our Western culture.  For me the opportunity to see and live this curriculum has been in Africa.   Here is what I can recommend from what I have found:
  1. We need to use the word healing.    
  2. We need to name healing when we see it happen in our patients.
  3. We need to name healing when we are the recipients as physicians, nurses and therapists
  4. We need to teach healing in our relationship with students and patients.
The best part of being in healthcare has been being a part of the larger story of healing.  It is a sustainable prescription to a suffering world.

Marvin

References

Boudreau JD;  Cassell EJ;  Fuks A. A healing curriculum.  Medical Education.  41(12):1193-201, 2007 Dec.

Previous blog references:
Hage, M. L. (2009). Healing at Tenwek.
Hage, M. L. (2010). Christian Surgical Mentoring.
Hage, M. L. (2012). Educational Partnerships.
Hage, M.L. (2012) Burnout and “Path Report”

Thursday, April 7, 2016

Another Kind of Healing

Julius, the carpenter, and the custom chair for a child with cerebral palsy
Tenwek Hospital, Kenya


He left there and returned to his hometown. His disciples came along. On the Sabbath, he gave a lecture in the meeting place. He made a real hit, impressing everyone. “We had no idea he was this good!” they said. “How did he get so wise all of a sudden, get such ability?”  But in the next breath they were cutting him down: 
“He’s just a carpenter—Mary’s boy. 
We’ve known him since he was a kid."    
Mark 6:1-3a (MSG)

I just finished a book by Kate Bowler, Blessed, A History of American Prosperity Gospel, that provided a deeper and wider look at healing as seen and understood in American religious culture.  It is a comprehensive history.

I have professionally and personally avoided this history.  Kate Bowler helped me understand two important issues: (1) Healing has been an important part of American culture and (2) religious healing has been seen mostly as rapid “cures”.  This book helped me to appreciate the importance of a bigger definition of healing that is not limited to a culture or cure.  

I read this book after spending a month in Kenya (Tenwek Hospital) where healing is embraced as central to their mission.  It’s meaning there is not about performance or a method of aggrandizement. It is God at work through the hands and feet of very dedicated and committed physicians, nurses, therapists and missionaries.  It is the body of Christ.  It even happens with healing hands of a carpenter!

Marvin

Bowler, K. (2013). Blessed: A History of the American Prosperity Gospel (1 ed.). Oxford University Press. 

Shuman, J., & Volck, B. M. D. (2006). Reclaiming the Body: Christians and the Faithful Use of Modern Medicine (The Christian Practice of Everyday Life) (1 ed.). Brazos Press.



Thursday, February 18, 2016

Healing Leprosy

Over 200,000 Cases of Leprosy in 2012

Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, ‘Unclean! Unclean!’.  As long as they have the disease they remain unclean. They must live alone; they must live outside the camp.
Leviticus 13: 45-46 (NIV)

While he was in one of the cities, there came a man full of leprosy; and when he saw Jesus, he fell on his face and besought him, “Lord, if you will, you can make me clean.”  And he stretched out his hand, and touched him, saying, “I will; be clean.” And immediately the leprosy left him.  And he charged him to tell no one; but “go and show yourself to the priest, and make an offering for your cleansing, as Moses commanded, for a proof to the people.”  But so much the more the report went abroad concerning him; and great multitudes gathered to hear and to be healed of their infirmities. But he withdrew to the wilderness and prayed.
Luke 5: 12-16 (NIV)


The Bible has descriptions of and laws related to leprosy and healing.  Did you notice that women are not identified in any of the leprosy accounts?  This probably represents the social isolation and stigma that accompanies this disease.  They probably did not survive the isolation.

I have not seen leprosy during pregnancy.  The challenge is how to treat and the effects of the treatment on the fetus and baby after delivery.  Let me briefly tell you of a patient that I recently saw:  

The patient was a 26 year old admitted with bacterial meningitis and pregnant around 24 weeks.  Her mother has been with her and provided the history.  She was treated with antibiotics and showed improvement.  What was more remarkable was her face with large painless nodules that have been there for the last six years.  I will not post a picture of the patient, but I will never forget her face.  It looks like the pictures of known cases with leprosy.  We still have to confirm the diagnosis with biopsy of the lesions and begin treatment. 

This case will probably not be resolved for a long time and will require multiple providers and resources that will be difficult to find.  A comprehensive treatment program is required that is more than just the medications.

What I learned again from seeing this patient is that God’s love continues to reach out to the poor, the outcast and the isolated.  Thanks be to God for his healing gifts!

Marvin


References


Duncan, M E. An historical and clinical review of the interaction of leprosy and pregnancy: a cycle to be broken.  Social Science & Medicine.  37(4):457-72, 1993 Aug.

 Morrison, A. A woman with leprosy is in double jeopardy.  Leprosy Review.  71(2):128-43, 2000 Jun

Saturday, January 23, 2016

Invited


“Go forth as a new doctor, conscious that everybody is to be revered, reverenced as created in God's image whether inner-city and rural areas go forth to demonstrate your Ubuntu, to care for them, to heal them especially those who are despised, marginalized. Go forth to make the world a better place for you can make a difference. The task is daunting of course, but it is our necessary struggle.”
Desmond Tutu, 
handwritten address delivered at 
Morehouse Medical School Commencement,
May 15, 1993.


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.
Matthew 25:35-36 (NIV)


I have been reading about the challenges to communities.  We are all members of multiple communities.  What holds us together?  What breaks us apart?  Who is “in” and “out”?  We would like to believe that in healthcare we could articulate clear answers to these “why” questions.

In college, I was assigned the novel, L’├ętranger by Albert Camus.  It was a difficult read with profound questions about the meaning of our lives and our disconnectedness. Camus’s stranger was profoundly separated from his community.  It may well be that this character is found in all of us during our most lonely times.  

The contrast to our isolation can be found in the big idea of ubuntu.  It is a great idea!  I even got a Christmas gift of a T shirt that clearly displays the message.  This belief is found in the words of Matthew as well as Bishop Tutu.

The “why” and purpose of community is a paradox as described in Matthew.  We are called, by invitation to inclusion.  Hospitality is the key to and for healing communities.  We have the wonderful opportunity, even as strangers, to be invited into the lives of those we serve and with that invitation; “we are”!


Marvin


References:

Michael Battle. Ubuntu: I in You and You in Me (Kindle Locations 518-520). Kindle Edition.

Block, Peter (2009-09-01). Community: The Structure of Belonging . Berrett-Koehler Publishers. Kindle Edition. 

Camus, A. (1971). L’├ętranger (Collection Folio, no. 2) (French Edition) (New edition ed.). Gallimard