We should always endeavour to wonder at the permanent thing, not at the mere exception. We should be startled by the sun, and not by the eclipse. We should wonder less at the earthquake, and wonder more about the earth. ~ G.K. Chesterton
As a physician, I’m trained to notice the exceptions – the human body equivalent of
an eclipse or an earthquake,
a wildfire or drought,
a hurricane or flood,
or a simple pothole.
Ordinarily I’m not particularly attentive to everything that is going well with the human body, instead concentrating on what is aberrant, out of control or could be made better.
This is unfortunate; there is much beauty and amazing design to behold in every person I meet, especially those with chronic illness who feel nothing is as it should be and feel despair and frustration at how their mind or body is aging, failing and faltering.
To counter this tendency to just find what’s wrong and needs fixing, I’ve learned over the years to talk out loud as I do physical assessments:
you have no concerning skin lesions,
your eardrums look just as they should,
your eyes react normally,
your tonsils look fine,
your thyroid feels smooth,
your lymph nodes are tiny,
your lungs are clear,
your heart sounds are perfect,
your belly exam is reassuring,
your reflexes are symmetrical,
your emotional response to this stress and your tears are completely understandable.
I also write messages meant to reassure:
your labs are in a typical range
or are getting better
or at least maintaining,
your xray shows no concerns,
or isn’t getting worse,
those medication side effects are to be expected and could go away.
I acknowledge what is working well before attempting to intervene in what is not.
I’m not sure how much difference it makes to my patient.
But it makes a difference to me to wonder first at who this whole patient is before I focus in on what is broken and what is causing such dis-ease.
Scars come in various sizes and shapes, some hidden, some quite obvious to all. How they are inflicted also varies–some accidental, others therapeutic, and too many intentional. The most insidious are the ones so deep inside, no one can see or know they are there.
Back in our woodlot stands a sawed off stump of a cedar that was old growth in virgin forest over a hundred years ago. One day the clearcut loggers came through our part of this rural county and took every tree they could to haul to the local sawmills to become beams and lumber for the growing homesteading population in the region. This cedar once was grand and vast, covering an immense part of the forest floor, providing protection to trillium at its feet and finches’ nests and raptors hunting in its branches. It nurtured its environment until other plans were made, and one day, axes fell on its sides to cut out the notches for the springboards where two loggers stood to man the saw which brought the tree down. Where the wood went is anyone’s guess. It could be one of the mighty beams supporting our old hay barn roof or it could have become the foundation flooring of a nearby one room school house. It surely had a productive and meaningful life as part of a structure somewhere until rot or carpenter ants or fire brought it once again to its knees.
But the stump remains, a tombstone of remembrance of a once grand tree, the notch scars embedded deep in its sides, nursing new seedlings from its center and moss, lichen and ferns from its sides.
I come from logger stock so I don’t begrudge these frontier settlers their hard scrabble living, nor minimize their dangerous work in order to feed themselves and their families. It’s just I’m struck by those scars even one hundred years later — such a visible reminder of what once was a vital living organism toppled for someone’s need and convenience.
Trees are not unique. It happens to people too. Everyday scars are inflicted for reasons hard to justify. Too often I see them self-inflicted in an effort to feel something other than despair. Sometimes they are inflicted by others out of fear or need for control.
Sometimes they are simply the scars of living, wounds accumulated along the pathway we tread, often to letting in Light where there was none before.
None of them are as deep and wide as the scars that were accepted on our behalf, nor as wondrous as the love that oozed from them, nor as amazing as the grace that abounds to this day because of the promise spelled out by them. These are scars from the Word made Flesh.
I pray because I can’t help myself.
I pray because I’m helpless.
I pray because the need flows out of me all the time — waking and sleeping.
It doesn’t change God — it changes me. ~C.S. Lewis
Almost four weeks ago I wrote about our little neighbor, two year old Faye Jubilee, sickened by E.Coli 0157 infection/toxin to the point of becoming critically ill with Hemolytic Uremic Syndrome (plummeting cell counts and renal failure). My post is found here:
At the worst point of her illness, when the doctors were sounding very worried on her behalf, Faye’s mother Danyale wrote to our Wiser Lake Chapel Pastor Bert Hitchcock with a plea for prayers from the church in the midst of her helplessness:
Here is how he responded:
“I understand that Faye (and everyone dealing with her) is fighting for her life. And that’s the way I am praying: that God in his merciful power, would deliver her, even if her condition looks hopeless.
If you were able to be in church this morning, you might hear my sense of urgency, for I have chosen this benediction, with which to close the service — and I give it to you right now, from the mouth of our Lord:
Jesus said: “Do not be afraid, Danyale!
I am the First and the Last.
I am the Living One.
I died, but look – I am alive forever and ever!
And I hold the keys of death and the grave.
Neither you nor I know how this will turn out — the possibilities are terrifying. But we do know who holds the keys of life and health and death; He is the Life-giver, who heals all our diseases — nothing can rip our lives (or little Faye’s life) out of His hands. And, when He does allow these bodies to give out, He promises to give us glorious new life, safe forever in His presence. These are not pious platitudes; these are the rock-hard promises of the one who loves us more than life, and who is absolutely in control of what is happening today.
Safe in the arms of Jesus,
Safe on His gentle breast;
There by His love o’ershaded,
Sweetly my soul shall rest.
I’m praying for you all; and the Chapel Family will be praying this morning, as we gather in the Lord’s presence.
Love you, and yours, Danyale,
Pastor Bert Hitchcock
And now Faye is home, with normal kidney function and improving cell counts, having also survived a bout with pneumonia.
Thanks to you all for your prayers lifted around the world on her behalf. Here is a summary from her mother:
Dear Friends and readers of Barnstorming,
Some of you we know, but so many of you we do not. Whichever the case, Emily tells me you have prayed for our little girl, Faye, throughout her sickness and into her recovery. What can parents say when people–many of whom we may never be privileged to meet in this life–have come alongside us to beseech the Lord for our daughter’s life and pray for her healing? Thank you. Thank you!
Faye is doing so well; stronger every day, more and more herself! It is wonderful to see.
This week we head back down to Seattle Children’s for a check up–we’ll get to say hello to the good folks who saw her through her sickness. A special stop will be made on the dialysis unit to see Nurse Kathy, a favorite of Faye’s. We anticipate a good report!
Thanks again for your love and support, far and wide. Truly astounding.
Danyale and Jesse Tamminga, for Faye, too
Our prayers of helplessness to God continue for the healing and strengthening of Towa Aoyagi, the fourteen year old son of Pastor Seima and Naoko in Tokyo, Japan, who remains paralyzed following a neck injury four weeks ago today. He is currently in rehab in Tokyo, trying to stabilize enough to come to the United States for state-of-the-art spinal cord injury treatment to learn how to live and thrive in his changed body.
God keep my jewel this day from danger; From tinker and pooka and black-hearted stranger. From harm of the water, from hurt of the fire. From the horns of the cows going home to the byre. From the sight of the fairies that maybe might change her. From teasing the ass when he’s tied to the manger. From stones that would bruise her, from thorns of the briar. From evil red berries that wake her desire. From hunting the gander and vexing the goat. From the depths o’ sea water by Danny’s old boat. From cut and from tumble, from sickness and weeping; May God have my jewel this day in his keeping. ~Winifred Lett (1882-1973) Prayer for a Child
This prayer has hung in our home for almost three decades, purchased when I was pregnant with our first child. When I first saw it with its drawing of the praying mother watching her toddler leave the safety of the home to explore the wide world, I knew it addressed most of my worries as a new mother, in language that helped me smile at my often irrational fears. I would glance at it dozens of time a day, and it would remind me of God’s care for our children through every scary thing, real or imagined.
When our eight year old daughter was hospitalized with a life threatening E.Coli 0157 infection, this prayer comforted me when she was so sick, as I knew only God’s care and keeping would make the difference in a condition where there was no proven medical treatment other than watching and waiting with intravenous fluids to prevent dehydration.
And now this poem is in my mind once again, prayed fervently for two children separated by a vast ocean, but united through God’s church family. One is our little neighbor Faye, turning two in three days, who also has E.Coli 0157 infection and is at Children’s Hospital in Seattle. Her life and her family are incredibly precious to us at Wiser Lake Chapel. Please pray with us that God will protect her through this awful illness, and give her parents endurance through long days and nights and an extra strength of faith and assurance of His love.
In Tokyo, Japan, we pray with our sister church Grace Harbor for their pastor’s son, Towa, age fourteen, who this week sustained a serious neck injury causing paralysis of his arms and legs. His healing and recovery will take much time and his long term outcome uncertain. He and his family too are having to depend on God’s power to help heal his body, and to prepare their hearts and minds for the unknowns and potential of life long challenges.
In addition to the two whose names we know, there are so many thousands of children hurting now in Nepal and other parts of the world, whose names we do not know, but who desperately need this prayer:
From cut and from tumble, from sickness and weeping; May God have my jewel this day in his keeping….
Let us not be surprised when we have to face difficulties. When thewind blows hard on a tree, the roots stretch and grow the stronger, Let it be so with us. Let us not be weaklings, yielding to every wind that blows, but strong in spirit to resist. ~Amy Carmichael
And so the government and its people are at an impasse–the winds of change are pummeling us all and everyone has entrenched more deeply in order to stay upright.
As a U.S. health care provider who has worked for over 30 years as a salaried physician, in non-fee-for-service health care settings providing patient care that meets the need when need arises without profit motive, I am flummoxed by this impasse. Policy makers could not come up with a more simplistic solution than what is contained in 2000+ pages of complex regulations that are already creating bureaucratic havoc in all health care settings, distracting health care providers with electronic and telephone paperwork that pulls us away from the bedside. The patient and the provider no longer partner together without a dozen other entities dictating the choreography of their dance.
A potential solution to the problem of affordable access to all who need it already exists in the form of the Public Health Service Commissioned Corps with incentive scholarships for medical and nursing training in exchange for work in under-served areas. An expansion of such a system, requiring funding at a much lower cost than the billions of dollars required by the current health care reform act, would address the challenges of the uninsured and the uninsurable.
As a medical student in training, I spent many months providing patient care in Seattle’s exemplary Public Health Hospital and its associated clinics. Patients traveled hundreds of miles to see the specialists who worked there; the best and the brightest clinicians saw the poorest of the poor inside those walls, but there were a number of physicians and their families I knew who received their care there as well because they knew the people who worked there were devoted to the patient, not to profit.
When the Executive, Judicial and Legislative branches of government refuse themselves to participate in a health care system they have constructed for the people, then it is not created of the people, by the people, for the people for they are people who get sick and injured just like the rest of us. What is best for them must be best for us all.
All citizens, and non-citizens inside our borders for whatever reason, should have easy access to affordable health care. All health care providers should have opportunity to work off the costs of their training to keep the debt load from crushing them for decades to come.
I am grieved that health care has come to this impasse, with government now in a take-no-prisoners mode that clear-cuts us all down to the bare roots.
We need to lean in together for support and quit the fighting that only creates more injury.
We need look no farther than our own commissioned corps of health care officers. It is an idea whose time has come.
The issue is now clear. It is between light and darkness and everyone must choose his side. ~G. K. Chesterton
…love has always sought to put back together that which hate has broken. …our hands have always been able to heal as much as harm. …since the dawn of humanity, each of us contains three people— the angel, the demon, and the one who decides which we will obey.
It should not require an act of evil for us to recognize the human capacity for love, caring and compassion. It should not take fearsome suffering and death of innocents to remind us all life is precious and worthy of our protection, when others would discard it.
We are created to choose sides. Our Creator chose to suffer to guarantee we are eternally worthy of His protection.
Astonishing material and revelation appear in our lives all the time. Let it be. Unto us, so much is given. We just have to be open for business. ~Anne Lamott from Help Thanks Wow: Three Essential Prayers
I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.
In a typical clinic day, I open that door 36 times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient. I need to peel through the layers of a person quickly to find the core of truth about who they are and why they’ve come to me.
Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fear. Most of the time, it is buried deep and I need to wade through the rashes and sore throats and coughs and headaches to find it.
Once in awhile, I can actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.
Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.
Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that can be overcome rather than overwhelming.
Always I’m looking for an opening to say something a patient may think about after they leave my clinic — how they can make better choices, how they can be bolder and braver in their self care, how they can intervene in their own lives to prevent illness, how every day is a thread in the larger tapestry of their lifespan.
Each morning I rise early to get work done before I actually arrive at work, trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon the day. I know I may be stretched beyond my capacity, challenged by the unfamiliar and stressed by obstacles thrown in my way. It is always tempting to go back to bed and hide.
Instead, I go to work as those doors need to be opened and the layers peeled away. I understand the worry, the fear and the pain because I have lived it too. I am learning how to let it be, even if it feels miserable. It is a gift perhaps I can share.
No matter what waits behind the exam room door, it will be astonishing to me.
I’m grateful to be open for business. The Doctor is In.