Vocation & Retirement

“Remembering Forward”

“Who do we want to be?”

On Being with Krista Tippett

9/8/2011

“It's a poor sort of memory that only works backwards,' says the White Queen to Alice.” ― Lewis Carroll, Alice's Adventures in Wonderland & Through the Looking-Glass

 Brothers and sisters, each person, as responsible to God, should remain in the situation they were in when God called them.

1 Corinthians 7:24 New International Version (NIV)

“You are retired?” is the most common question when I meet colleagues that I haven’t seen recently.   It is a reasonable question since most of my medical school colleagues are retired.   The better question for me is what does vocation look like at the end of full-time practice?

There are a lot of books about retirement and even some studies regarding surgeons.   It seems to me that approaching the question from a vocational perspective is different than most of the books and the studies of physicians.  A report from physician Dr.  N. Thomas Connally gives us his personal and vocational account of retirement. (Select this report by clicking on it to see his video report.)

Vocational questions mandate looking back at the “direction of your life” and naming the “call”.  The good news is that “age” gives us the benefit of seeing our story and its themes.  Sometimes we find the answers and examples in other vocations.  The CD “Paul Simon Songwriter” is a wonderful summary of the vocation of Paul Simon.   We would not even think of asking the question, “When are you going to retire?”   He will always be “Paul Simon Songwriter”.

For me the question of retirement from being an actively practicing physician does not have vocational meaning.    The real question is not retirement but vocation.   What new aspects of my vocation do I need to address?   What are the missing pieces that have yet to be mastered?  I have come to believe that my “call” has not changed even if full time practice stops.  

Marvin

References

http://www.onbeing.org/program/who-do-we-want-become-remembering-forward-decade-after-911/257

http://www.goodreads.com/work/quotes/2375385-alice-s-adventures-in-wonderland-and-through-the-looking-glass

Luce EA. The ageing surgeon. [Review] Plastic & Reconstructive Surgery.  127(3):1376-83, 2011 Mar.

http://www.paulsimon.com/us/music/songwriter

Hope

“In a "medicalized" dying death is regarded as the great enemy to be defeated by the greater powers of science and medicine.”

Allen Verhey. The Christian Art of Dying: Learning from Jesus (Kindle Location 107). Kindle Edition. 

The recent book, The Cost of Hope,  Amanda Bennett chronicles the realities of end- of-life care in the United States.   It is a personal memoir of a fascinating, intelligent man written by a caring  and insightful wife.  Their story is not about lack of care but about the “medicalization” of death in our society.  It is an honest and powerful story even in her denial of what was obvious to others.   “Was I insane? Was I outrageous? Not at all, he answers. You were typical.”

Allen Verhey, writing from a perspective of a Christian bioethicist facing a lethal disease, describes the medicalization but also sees another dimension of dying.  He sees “Hope” not in the technology, although he is grateful for it, but in the community of faith and a belief in a larger Christian story.

So how are healing agents to behave in the the context of the medicalized culture?  What is key is our belief about hope and grace.   We must move to another facet of our faith as expressed in the arts.   A wonderful example is the music and images by Jonathan Elias  in the Prayer Cycle.   Here are two selections on “Hope” and “Grace”


Marvin

Bennett, Amanda (2012-06-05). The Cost of Hope: A Memoir (p. 213). Random House, Inc.. Kindle Edition.

Healing Peace

Rejoice in the Lord always. I will say it again: Rejoice!  Let your gentleness be evident to all. The Lord is near.  Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.  And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.   Philippians 4:4-7 (NIV)

We are all confronted by questions that challenge who we are, what we have done and what we plan to do.  In the book, Not Sure, A Pastors Journey from Faith to Doubt, John Suk shares the struggles of his journey and vocation.   The stimulus for his deep distress are both the challenges of suffering and the failures of belief systems  that have not kept promises of progress.   His story is similar to Barbara Brown Taylors report, Leaving Church,  A Memoir of Faith.   Both are important voices of faith in a complicated world of change within and outside the church.

What resonates in my life is that despite our reflection and study, relief comes both in patience and actions...Patience in that quick answers are frequently incomplete and actions that build a new direction not a destination.   The “crisis of compassion” or “crises of faith” are examples of those difficult times that move us.  It is a common event of lives in transition.  It is a time of making peace with the realities.   

This healing peace does not leave us sitting!  Both authors end their books not with a spirit of loss, but with new directions.  These are lessons for all of us...a peace that transcends all understanding; a healing peace.

Thanks be to God for kept promises and moving us from thinking to action.

Shalom,

Marvin

"Everybody Dies"

                          Scene from the final episode of "House" - 5/21/2012

The ending of the story of Dr. House after 8 seasons of conflict tells what we all know about the statistics of medical care...”everybody dies”. * But is this all we can say? 

“Dr. House” ends with review and reflection as he addresses the meaning of death and ends with what looks like a “bucket list” of unfilled dreams.  He certainly makes the case that “life is hell” and that death looks better.  The ambiguous argument is portrayed in a pyrotechnic ending as only Dr. House could do!

In another look at life, Donald Miller in his book, A Million Miles in a Thousand Years: What I Learned while Editing my Life, sees life as a holy story.   Both narratives testify to pain and suffering, but there is a difference.  Donald Miller’s story also identifies suffering but ends with courage and hope that ultimately comes from his faith. 

“Do I still think there will be a day when all wrongs are made right, when our souls find the completion they are looking for? I do. But when all things are made right, it won’t be because of some preacher or snake-oil salesman or politician or writer making promises in his book. I think, instead, this will be done by Jesus. And it will be at a wedding. And there will be a feast.”

These “life stories” address “the meaning” of both life and death and I am thankful for both.  It has helped us all to see our own stories more clearly.   I love the clarity of the first question and answer in a 16^th century statement that addresses the same difficult questions.

Heidelberg Catechism

Lord’s Day 1

Q & A 1

Q.

What is your only comfort

in life and in death?

A.

That I am not my own,

but belong—

body and soul,

in life and in death—

to my faithful Savior, Jesus Christ.

Marvin

References:

Summary of last episode

Miller, Donald (2009-08-26). A Million Miles in a Thousand Years: What I Learned While Editing My Life (p. 206). Thomas Nelson. Kindle Edition. 

Heidelberg Catechism

Rx Ubuntu

“So I figured, if the entire world was one big machine, I couldn't be an extra part. I had to be here for some reason...”  Movie quote by Hugo Cabret in the 2011 movie Hugo directed by Martin Scorsese

For by the grace given me I say to every one of you: Do not think of yourself more highly than you ought, but rather think of yourself with sober judgment, in accordance with the faith God has distributed to each of you. For just as each of us has one body with many members, and these members do not all have the same function, so in Christ we, though many, form one body, and each member belongs to all the others.  

Romans 12: 3-5 (NIV)

There are ideas that you learn about and ones that you experience.  If experience is first, we then try and attach a word or concept to that experience.  Looking back at our experiences in Kenya, we felt a deep connectedness to the Tenwek community that is hard to name.   When in South Africa visiting the townships, we were introduced to the African concept of “Ubuntu” that has deep roots in that culture.   

Shortly after returning, I read the Diana Butler Bass book, Religion after Christianity and again there it was, “Ubuntu” as articulated by Archbishop Desmond Tutu.  Could I put our recent experiences into this big idea of “Ubuntu”?  I needed a new voice, a cross-cultural voice, one that knew and lived in both cultures.   Enter Rev. Dr. Michael Battle!     

What I learned is that “Ubuntu”  is an important Christian idea that generally has been missed in our Western culture and Christian theology.   How did we miss it?   Even when apartheid was being removed by the church that supported it,  what did we understand was the theology to replace it?   I missed it!   Well, probably what really happened is that even though I heard the concepts in the message of Desmond Tutu on January 19, 1986 in Duke Chapel, I had not experienced and named it!

So for slow learners, we need new examples.  What maybe is happening is that we are now understanding the concept in other ways... in movies like Hugo, with its message of interdependency and the critical importance of purpose (telos) in our lives.  Now, I hear the message of “Ubuntu” in the wonderful songs and rhythms of Ladysmith Black Mambazo and the ballads of Paul Simon.  Now we have a name for these experiences!   Thanks be to God as he continues to work in our hearts and minds.   

N’Kosi Sikelel’ lafrica (God Bless Africa),

Marvin

References:

Bass, Diana Butler   Christianity after Religion:  The End of Church and the Birth of a New Spiritual Awakening, HarperOne, 2012

Battle, Michael Ubuntu: I in You and You in Me Seabury Books, New York, 2009

Speech delivered at Duke Chapel by Bishop Desmond Tutu

http://dukespace.lib.duke.edu/dspace/handle/10161/1709

God, Trials and Fears

Conquering Fear on Table Mountain - Capetown, SA

But Daniel appealed to a steward who had been assigned by the head of the palace staff to be in charge of Daniel, Hananiah, Mishael, and Azariah: "Try us out for ten days on a simple diet of vegetables and water. Then compare us with the young men who eat from the royal menu. Make your decision on the basis of what you see." 

Daniel 1:11-13 (The Message)

Certainly people have been putting God on trial for a long time and Daniel’s account is one of my favorites partially because it is also the first reported clinical trial.   What seems critical to me is that it wasn’t just a clinical trial, it was a clinical trial that pointed not just to the results but pointed to God and Daniel’s faith.

 The “us” in the Daniel story are two social economic classes.   Will the “rich” win or are there other dimensions that are more important?   In a technical and complicated world our trials point more to confusion and chaos rather than the God of life that sustains us.

A contemporary version of the Daniel story is the relevance of the church and reality of 

faith in our lives...what we believe, how we behave and where we belong?*   The problem with the question is that it is more about “we” than about God.   The better questions are “What is God calling us to do as individuals and his Church?”.  What is grieving God that needs to be healed? 

For me, it is our deep-seated “fears” that somehow have escaped the faith that we have professed.   It has been “anesthetized” by our drugs  and diverted with a futile faith in technology, but it remains!   We are healed of these “fears” when we tell our faith stories and hear/learn from the ancient stories.   The good news is the church is still the location where we hear and tell God stories.**  These are stories of God’s healing work in the world.  This is the prescription for our “fears” and manna for our lives.

Marvin

Some recent references:

*Diana Butler Bass - 

Huffington Post - 4/8/12  - A Resurrected Christianity?

                     Book:  Christianity after Religion:  The End of Church and the Birth of a New Spiritual Awakening(2012)

**See Fuller Seminary Service with Father Greg Boyle, S.J. -

Tears Wiped Away, Death Swallowed Up: Victorious Meaning and the Risen Life of Gang Members  http://vimeo.com/40191160

See Post: February 1, 2012 - Techniques and Transformation

Recognizing Healing

Surgical Procedure Board - Tenwek, Kenya

It was a day like many others at Tenwek Hospital(2/2012) when during rounds it was announced that two term pregnant patients arrived with seizures.  Both patients were diagnosed with eclampsia, both delivered.  The first patient’s baby was an early neonatal death, the other patient’s (JR) baby was small but survived.   The first mother improved quickly, but JR had evidence of renal failure, liver changes and the most obvious was her altered level of consciousness and subsequent hallucinations.   These symptoms required treatment with anti-psychotic medication.   Two weeks after presentation, JR suddenly became engaged with her baby, smiled and interacted appropriately with her family and providers.  Her renal failure and liver failure resolved. She remained in the hospital to continue to care for her baby.  


The reasons for resolution of this life threatening complication of pregnancy are only partially explained by her care.  What is most amazing is the long list of possible etiologies and mechanisms of injuries.  The patient and her family believe that she was healed.   Physicians and nurses use longer explanations about mechanisms and the sources of the dramatic change.   


These cases are a source of encouragement for those who work in very difficult settings with limited resources.   I believe that this case is a wonderful lesson in ”Let the living, teach the living” and another example of the “mystery of healing”!

Marvin

See previous blogs:

The Awe of Healing - January 15, 2012 

A Right Mind - September 5, 2011

The Mystery of Healing - April 17, 2011

Thackeray EM.  Tielborg MC. Posterior reversible encephalopathy syndrome in a patient with severe preeclampsia. Anesthesia & Analgesia.  105(1):184-6, 2007 Jul.

Belogolovkin V.  Levine SR.  Fields MC.  Stone JL. Postpartum eclampsia complicated by reversible cerebral herniation. Obstetrics & Gynecology.  107(2 Pt 2):442-5, 2006 Feb.