Called to Advent–treasuring

photo by Josh Scholten

But Mary treasured up all these things and pondered them in her heart.
Luke 2:19
Then he went down to Nazareth with them and was obedient to them. But his mother treasured all these things in her heart.
Luke 2:51

A heart is never completely empty of blood. Only a portion is pumped out of the ventricles with each contraction of the muscle, with some small residual remaining behind in the chamber. The larger the residual, the less effective the pump mechanism is, which becomes known as heart failure, resulting in less oxygen to the body. A normal healthy heart always holds on to a bit of life blood, sending the rest out to circulate and nourish the rest of the body organs.

It seems Mary had a great deal to hold in her heart–it must have been a very strong and powerful organ to handle so much in her lifetime. It was her repository for memories that were precious to her, things she never wanted to forget, events she wanted to tell someone to write down on her behalf someday. It was her storage space for her wonder at what took place before her eyes–the glorification of her son at His birth, the acknowledgement from others that she held God in her arms, that she was able to gaze into His face. He, from a very young age, would teach her more than she could ever teach Him. Her heart literally fed Him during her pregnancy, His heart beating beneath hers. During His childhood and later, her heart poured out love for Him and eventually His heart bled out for us all.

She shows us how we must store up the treasures most precious to us–not worldly things like money and jewels, but the memories of family, the nurture of trust and faith, the healing balm of sacrifice and grace. A heart full of that kind of treasure can never fail.

Where your pleasure is, there is your treasure; Where your treasure is, there is your heart; Where your heart is, there is your happiness.

You must keep all earthly treasures out of your heart, and let Christ be your treasure, and let Him have your heart.
Charles Spurgeon

Mary and Jesus painting by Pierre Mignard

Called to Advent–sowing

photo by Nate Gibson

Sow your seed in the morning, and at evening let your hands not be idle, for you do not know which will succeed, whether this or that, or whether both will do equally well.
Ecclesiastes 11:6

Sowing and sown. We become sower, soil and seed, as well as fertilizer, harvester, storage manager and consumer. We become farmers when it comes to the planting, feeding and watering of the Word in fertile hearts and minds.

It’s what you sow that multiplies, not what you keep in the barn.
Adrian Rogers

The almost impossibly hard thing is to hand over your whole self to Christ. But it is far easier than what we are all trying to do instead. For what we are trying to do is remain what we call “ourselves” – our personal happiness centered on money or pleasure or ambition – and hoping, despite this, to behave honestly, and chastely and humbly. And that is exactly what Christ warned us you cannot do. If I am a grass field – all the cutting will keep the grass field less but won’t produce wheat. If I want wheat…I must be plowed up and re-sown.

C.S. Lewis – Essay on “Is Christianity Hard or Easy?”

Called to Advent–rejoicing

photo by Josh Scholten

…and my spirit rejoices in God my Savior.
Luke 1:47

(As servants of God)..sorrowful, yet always rejoicing; poor, yet making many rich; having nothing, and yet possessing everything.

2 Corinthians 6:10

There is not one blade of grass, there is no color in this world that is not intended to make us rejoice.

John Calvin

Americans must be the most privileged people on earth yet we still grumble despite living in freedom in relative security. There is so little joy in our modern age of abundance. Is our cup half empty or half full? Why do we groan about what we lack and not stop to appreciate what all we have been given?

Rejoicing is expressing delight at what is, and having no regrets about what is not. There can be joy in times of sadness, we can be enriched by sharing what we have, and fulfilled without accumulating every material possession. As Augustine says: a happy life is rejoicing to God, of God and for God. He didn’t mention a larger house, faster car, exotic vacations, or the best plastic surgery.

So we read the words of profound joy expressed by Mary when her life is suddenly turned upside down and her body no longer in her control. She is happy and willing because she trusts the Lord despite all the unknowns. The shepherds, the lowest segment of society just above lepers, were first to be given a message of praise and glory from the heavens. Once their fear abated, they became so joyful and excited, they wanted to share all they had heard and seen with anyone who would listen.

It is our turn now. It is time to be gruntled, not disgruntled, happy to be alive instead of sorrowful, so we might rejoice mightily in the infinite gift we’ve been given.

This is it; there is no other.

And this is the happy life, to rejoice to Thee, of Thee, for Thee; this it is, and there is no other.


Adoration of the Shepherds by Correggio

Called to Advent–quieting

photo by Josh Scholten

He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing.
Zephaniah 3:17b

Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight.

1Peter 3:4

When worries overwhelm and fretting becomes fearsome, I need quieting.
When the noise of news headlines screams for attention, I call out for quieting.
When there is sadness, conflict, tragedy, illness, estrangement in family and friends, I long for quieting.
When too many balls are juggled at once, and the first one is dropped with three more in the air, I desire quieting.
When the ache lasts too long, the tiredness lingers, the heart skips a beat, and one too many symptoms causes anxiety, I am desperate for quieting.
When tempted and ready for surrender, forgetting confidence, conviction, commitment and faith, I pine for quieting.
I need to freeze in place, be unmoving, and stay completely still so I can be a reflection of the depths of restoration and rest
Found in the call to quieting.

Just remaining quietly in the presence of God, listening to Him, being attentive to Him, requires a lot of courage and know-how.

Thomas Merton

If we have not quiet in our minds, outward comfort will do no more for us than a glass slipper on a gouty foot.
John Bunyan

Thou hast created us for Thyself, and our heart is not quiet until it rests in Thee.


photo by Josh Scholten

Called to Advent–pondering

But Mary treasured up all these things and pondered them in her heart.
Luke 2:19

There are times when all we can do is sit back and wonder at what is happening around us. It may make no sense, it may seem completely foreign or irrational. We have a choice to either back away from what is completely beyond our understanding, or plunge in head first in faith, trusting that what counts is that at least it makes sense to God.

Mary was exactly in that position as a new mother. She treasures up, she marvels at and she ponders all that she hears and sees, knowing but not completely fathoming that she has delivered the Deliverer.

We need to spend time in wonder too. We are stunned and amazed at the depth of the Father’s love that brought Him into our arms only to be cruelly rejected just as He pays our debts in full. This is the kind of story that makes no sense at all except to God. We couldn’t have made this up, not in a million years, no matter how hard we tried. It’s just as well–because we are not the Word, and He is.

This is the irrational season
When love blooms bright and wild
Had Mary been filled with reason
There’d have been no room for the child.

Madeline L’Engle

Called to Advent–overflowing

photo by Josh Scholten

…continue to live your lives in him, rooted and built up in him, strengthened in the faith as you were taught, and overflowing with thankfulness.
Colossians 2: 6b-7

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.
Romans 15:13

May the Lord make your love increase and overflow for each other and for everyone else, just as ours does for you.
1 Thessalonians 3:12

Overflowing has always been something I’ve been particularly good at, especially first class in the category of overflowing tears. My family knows it doesn’t take much to get my lacrimal faucets going: saying goodbye, saying hello, listening to a childrens’ choir singing, listening to any of our own children singing, a heartstring-tugging commercial on TV, the whistled “Greensleeves” theme to the old Lassie series, not to mention the whistled theme to the old “Leave it to Beaver” or “Andy Griffith” series–you name it, whistling does it.

I would like to think that I’m overflowing with thankfulness, hope, joy and love but it may just be, as my husband suspects, that I’m suffering from an overabundance of sentimentality and nostalgia. …whatever.

He’s right. My easy tears and emotions run amok are not proof my tank is full or my heart overflows. It is only through the power of the Spirit–through the work of His Word preached faithfully each week, feeding my hunger, slaking my thirst, supporting my weakness, easing my emptiness–that I find my heart filling up, bit by bit.

There was a moment today after worship together as a church and a powerful sermon. I watched the Sunday School Children rehearse their parts for next week’s Christmas Childrens’ Program, as a two year old “angel” clasped her hands in prayer over an imaginary manger. I could see what she “saw”. She was looking into the face of God, watching Him sleep, in her mind’s eye. My heart filled even more. I wanted to look into that “manger” right along with her.

I hope when I overflow, it is with Spirit, not sentiment and I continue to look for His face wherever I go.

When the heart is full of joy, it always allows its joy to escape. It is like the fountain in the marketplace; whenever it is full it runs away in streams, and so soon as it ceases to overflow, you may be quite sure that it has ceased to be full. The only full heart is the overflowing heart.
Charles Spurgeon

A beam of God’s countenance is enough to fill the heart of a believer to overflowing. It is enough to light up the pale cheek of a dying saint with seraphic brightness, and make the heart of the lone widow sing for joy.
Robert Murray McCheyne

Adoration of the Shepherds van Honthorst

Called to Advent–naming

photo by Josh Scholten

He determines the number of the stars; He gives to all of them their names
Psalm 147:4

We were given the task of naming the things of creation right at the beginning: plants, animals, rocks and even the heavens. In our modern world, it is a lost art for most people to have learned the names of things in nature, often no longer caring about the order, the taxonomy and species, the Latin name or even common name. We have lost the intimacy of knowing the name of what and who we walk among every day.

Not so with God. Not only the stars reflect His naming but He calls us by name as well; Abraham, Moses, Samuel, Mary, Peter, Ananias, Paul among others– all heard their name uttered by the voice of God. He knows who we are and in His intimate relationship with us, he cares enough to summon us by name.

It is up to us to be listening closely enough to hear. It is up to us to be ready to respond.

“Lucy woke out of the deepest sleep you can imagine, with the feeling that the voice she liked best in the world had been calling her name.”

― C.S. Lewis, The Chronicles of Narnia

Called to Advent–magnifying

Botticelli Magnificat

And Mary said: “My soul magnifies the Lord”…
Luke 1:46

The Incarnation allows us to see and hear and touch what we could only glimpse before in a pillar of smoke, a tabernacle, a burning bush, a still small voice. God becomes magnified in the manger with unmistakable clarity and focus. He is rocked and fed, picked up when He falls, comforted when He cries, guided and taught and loved.

What was once remote from us is now up close, magnified like a setting moon becoming huge on the horizon at dawn. He has settled among us. He has become us.

“These still December mornings…
Outside everything’s tinted rose, grape, turquoise,
silver–the stones by the path, the skin of the sun

on the pond ice, at the night the aureola of
a pregnant moon, like me, iridescent,
almost full term with light.”

Luci Shaw in “Advent Visitation”

Called to Advent–listening

photo by Josh Scholten

The LORD came and stood there, calling as at the other times, “Samuel! Samuel!” Then Samuel said, “Speak, for your servant is listening.”
1 Samuel 3:10
But the angel said to them, “Do not be afraid. I bring you good news that will cause great joy for all the people.When they had seen him, they spread the word concerning what had been told them about this child, and all who heard it were amazed at what the shepherds said to them.
Luke 2: 10 and 17-18

The Advent story is full of listening people. They listen to Caesar Augustus, to angels, to shepherds, to Herod, to Simeon and Anna in the temple. It took great courage to simply listen and pay attention–to hear what was frightening, amazing, terrifying, joyous, distressing, fulfilling.

We too listen to this story with amazement and joy, forgetting the fear, knowing the end of the story and what it means for our lives. We are called to continue listening throughout our lives: for the angel song, for the blessing, for the spreading of good news, and particularly and especially–for the sound of God’s heartbeat here on earth.

Just remaining quietly in the presence of God, listening to Him, being attentive to Him, requires a lot of courage and know-how.
Thomas Merton

Hearing Hoofbeats

It is critical for physicians to share unusual patient diagnoses that present to clinic with routine type symptoms. In a hospital setting, these are cases for discussion and debate at Grand Rounds. In a primary care setting, we do case reviews when we can with informal sharing for the purpose of teaching and learning. The bottom line, whether in a formal academic setting, or an informal setting around the lunch table: clinicians need to always be thinking of the possibility of a zebra hiding in camouflage among the many ponies in the primary care setting.

After twenty two years working as a physician in college health and seeing two or three extraordinary cases every year, suddenly I’ve seen three “once in a career” patients in the last three months.

Several weeks ago I saw an otherwise healthy student with an unusual rash and history of nightsweats for two weeks. The well circumscribed large erythematous lesions matched photos I looked up of erythema marginatum which can occur with rheumatic fever from Group A strep infection. The student had never had a sore throat but did have a positive rapid strep test that day as well as a markedly elevated streptozyme and sed rate, and met other clinical criteria of rheumatic fever. The infectious disease consultants agreed. Thankfully the student was diagnosed and treated early enough that echocardiogram was normal. The rash and sweats disappeared within 48 hours on Penicillin VK. This is believed to be the only case of rheumatic fever in our state this year.

Last week I saw an otherwise healthy student with a history of a pet rat having bitten an index finger a week before. The bite healed without intervention but the student was feeling generally unwell with headache, nausea, fever, chills and muscle and joint aches, as well as a new macular rash of discrete erythematous lesions on palms and soles, extending to the dorsum of the feet. All symptoms appeared classic for rat bite fever, a rare infection by Streptobacillus moniliformis with a 25% mortality rate if left untreated. Blood cultures remain negative but must be kept at least three weeks for this particular bacteria. The patient has finished a week of IV antibiotics while remaining in school and all symptoms have improved. There are apparently very few cases in the U.S. annually but since it is not reportable, the incidence is unclear.

Also last week an otherwise healthy student was hospitalized in septic shock after being seen twice in emergency rooms while home over Thanksgiving break–fever, sore throat, nausea, muscle aches that appeared viral to the evaluating clinicians. The student came back to school still sick, went to the local emergency room when feeling so lightheaded that walking was difficult, ended up in ICU on a ventilator due to incipient respiratory failure. It took several days of touch and go clinical management for the diagnosis to become clear: Lemierre’s Syndrome–septic thromboembolism to the lungs that results from a gram negative infection in the throat and causes deep pharyngeal abscesses, with a jugular vein that becomes infected with septic emboli. The student was initially placed empirically on three antibiotics by the infectious disease specialist so was being appropriately treated even before the diagnosis was obvious, and will likely be on IV antibiotics at home for up to eight weeks due to the persistence of the emboli. Lemierre’s is something that is reported two or three times a year in young adults nationally and carries a significant mortality rate.

These three patients have survived these devastating infections. I’m very humbled by the fact that presentation of routine symptoms in a young adult primary care population should never leave the clinician complacent about what the potential cause might be.

The zebra just might be hiding in the bushes, right in the middle of a herd of horses.