I was listening to this tonight and thought that this was a good song to sum up my experience at SMI.  It's hard to live in the past, but what if the life you lived in the past was but a small glimmer of the shining brightness that the future holds?

Summer Medical Institute - In Brief

This photo sums up the essence of my summer medical institute experience. It’s one of my favorites, not because of the quality of the photo—it didn’t even make Dan Chen’s photo binge—but because of the stories behind it. They are stories that cannot be told in pictures (since they do not exist), stories that have altered my life, stories that I pray mark the beginning of a journey and not its end.
The photo was taken on July 9th; we were at a dinner/ice cream social that was hosted for the students and translators. As I was chatting with some of the translators I saw Dr. Leibert and flagged him down. I shared with him a story that began a work in my heart; it was the story of a little girl named Mayra.

We had one more house to see before our vans were leaving the Texas colonia. I prayed for our group as we walked up to the beautiful pink stucco home—it stood out against the stark backdrop of trailers and shacks. The inside was equally beautiful: clean tile floor, elegant furniture, and fine furnishings. We were warmly welcomed but within minutes our translator was occupied with one of the older girls and I was without proper communication with mother. When I asked to see if there was someone who could translate for me that’s when Mayra came out of a room in the back of the house. I asked mom a few health related questions and took her blood pressure. Thankfully our translator came back and started talking to mom. I was left with a little 11 y/o Mayra and struck up a conversation. As I struggled to find the words to say to bring this girl the gospel I got a Bible and began to read key passages. Her response: “I want Jesus to be my Savior.”

The photo was taking immediately after I shared this story with Dr. Leibert, he prayed right then that God would continue to develop this vision of bringing the gospel through medicine. God certainly did what he asked. Three days later I spent the day seeing patients with a doctor and translator at a fishing village. We prayed with every patient and brought each one the good news of Jesus.

That’s when 6 years of experience being part of a fast paced medical team in the ER became meaningless. All those cardiac arrests, aortic dissections, traumas, CVAs, and heroin overdoses faded out of my mind. I stopped thinking about the next best case to see, the next exciting drama-queen patient, or the once-in-a-lifetime condition…because medicine finally became satisfying that day.

We go through life chasing after the next best object, person, or experience, perhaps the summer medical institute was one of those experiences I chased after. But what God taught me wasn’t through a grandiose experience; it was a small flicker that few noticed, a slight shift in my life goals and direction, it was by living out the gospel through an activity that any medical person could perform. Medicine alone will be ultimately dissatisfying but medicine with a purpose—to give people as much Jesus as they will take—is eternally gratifying.

Will there be any lasting impact? Only God knows if this will be the end of a journey, but oh, how I hope that this is just a glimpse of the beginning!

“Whoever drinks of this water will thirst again, but whoever drinks of the water that I give him will never thirst. But the water that I shall give him will become in him a fountain of water springing up into everlasting life.”
John 4:13-14

Songs

I went home this week and rediscovered a few CDs that I had listened to back in high school yet never copied to my computer. Two songs in particular stood out:

Sure Shot (Supertones)

I wanna do the right thing.
I wanna be the sure shot.
I wanna have my mind straight.
I wanna have my point got.
I wanna be a good man,
I wanna have my act down.
I wanna be the future
and I wanna be right now.

Sometimes I feel
like I can change the world.
But I don't know where to start.
I dig and come up empty,
clutching an empty heart.

I wanna see a life change.
I wanna see a new man.
I wanna fight the good fight.
I wanna take the right stand.
I wanna be like Jesus.
I wanna pour my heart out.
I wanna pick my cross up.
I wanna hear the mob shout.

I'm wide awake
and thinking about the cross,
the Trinity apart.
I dig and come up empty,
clutching an empty heart.

I wanna do the right thing.
I wanna be the sure shot.
I wanna have my mind straight.
I wanna have my point got.
I wanna be like Jesus.
I wanna pour my heart out.
I wanna pick my cross up.
I wanna hear the mob shout.

Sometimes I feel
like I can change the world.
But I don't know where to start.
I dig and come up empty,
I'm wide awake
and thinking about the cross,
the Trinity apart.
I dig and come up empty,
clutching a sacred heart.


When Christ comes and changes a man, it doesn't mean that he will suddenly become unsuccessful, aimless, and unassertive. However, it does mean that he will want his see his life change, fight the good fight, take the stand on the right side, be like Jesus, pour his heart out, pick up his cross, and be prepared to hear the mob shout against him. The Supertones beautifully merged these two aspects of men together. Here is a picture of a man who takes initiative for his own future, a desire to change the world, and a passion for his life to be transformed by Christ. His heart is empty because it is sacred, it is poured out not for his own interests but for the interests of others.

Always and Forever (Raze)

The stars will shine
The moon will glow
The sun will rise
The grass will grow
Some things will never change
Just like me and you
Mountains high and valleys low
I have got to let you know
That I am here for you
Whatever you go through

Troubles come and get you down
I'll always be around to say

CHORUS:
I will be here always and forever
I'll be here for you
we will be friends(strong)
forever and ever

As far back as I can remember
Thirty-one days in the month of December
Life will still go on
But it's just not the same
Miles and miles and miles are between us
Like Earth to Mars and then on to Venus
Although you have gone away
I still see your face

And these memories linger on inside our
hearts always!

I will be here always and forever
I'll be here for you
we will be friends(strong)
forever and ever


When I ripped this song onto my computer the song title came up was "Always and Forever(Bff)." We live in a transient society and culture. Life changes in what seems the blink of an eye. Each of us yearns for something permanent, something lasting. This I believe is one aspect of a God-shaped hole in our lives. Eternal beings in a temporal world will inherently yearn for something eternal. Thus, our dissatisfaction with worldly things and a constant chasing after something more, something better.
Can friends last forever? I know a lot of people and I can go many places on the east coast (and even the US) to see people who are my "friends." But are they really friends? I spent time with them in the past, and I "did life" with them previously. I know an incredible amount of people within a 50 mile radius, but I can't say that I am truly friends with any more than a handful of them.

Why? Because I don't share life with them. They aren't the ones I confide with, share my troubles with, or those who are there for me in the hardest of times.
Why? Because they're not around anymore.

Maybe it's because I'm in a profession that endlessly demand time from me and I choose to pour myself into it and related activities. I wonder if I can actually be friends with someone forever. In 3 years I might be somewhere else on the planet. May I make the most of the opportunities I have now to invest and be invested in by those around me so that I may not live in the past but rather in the present with eyes that are focused on the future.

Plans...

"And he began to teach them that the Son of Man must suffer many things and be rejected by the elders and the chief priests and the scribes and be killed, and after three days rise again. And he said this plainly. And Peter took him aside and began to rebuke him. But turning and seeing his disciples, he rebuked Peter and said, Get behind me, Satan! For you are not setting your mind on the things of God, but on the things of man. And he called to him the crowd with his disciples and said to them, If anyone would come after me, let him deny himself and take up his cross and follow me. For whoever would save his life will lose it, but whoever loses his life for my sake and the gospel's will save it. For what does it profit a man to gain the whole world and forfeit his life? For what can a man give in return for his life? For whoever is ashamed of me and of my words in this adulterous and sinful generation, of him will the Son of Man also be ashamed when he comes in the glory of his Father with the holy angels."
Mark 8:31-38

The disciples maintained an ingrained mindset that the kingdom of God was a material, physical kingdom and the Messiah would come, rescue them from the heavy hand of the Romans, and reestablish the kingdom of Israel. So when Jesus, the very Son of God, declared that he would be rejected and killed it was too much for Peter to handle. I mean, how could their very Messiah be rejected by the chief leaders of the Jews? Killed?

I often relate to Peter. I have a vision of what God's kingdom is and what it looks like.
But is it God's vision?
Am I ready to be rebuked by Jesus when my thoughts are not His?
Am I willing to sacrifice my ideas of where God is taking me to God's eternal, sovereign, and loving plan?
Are my "kingdom" plans the plans of man and not of God?

Am I ready to see my plans rejected, cursed, spit upon, beaten, and nailed to a cross so that countless millions would enter the kingdom of God?

I hasten towards an hour
when earthly pursuits and possessions
will appear vain,
when it will be indifferent whether I have been
rich or poor,
successful or disappointed,
admired or despised.
But it will be of eternal moment that I have
mourned for sin,
hungered and thirsted after righteousness,
loved the Lord Jesus in sincerity,
gloried in his cross.
~Valley of Vision (Openness)

No Reserve, No Retreat, No Regrets

In 1904 William Borden graduated from a Chicago high school. As heir to the Borden Dairy estate, he was already a millionaire. For his high school graduation present, his parents gave 16-year-old Borden a trip around the world. As the young man traveled through Asia, the Middle East, and Europe, he felt a growing burden for the world's hurting people. Finally, Bill Borden wrote home about his "desire to be a missionary."1
One friend expressed surprise that he was "throwing himself away as a missionary."
In response, Bill wrote two words in the back of his Bible: "No reserves."
Even though young Borden was wealthy, he arrived on the campus of Yale University in 1905 trying to look like just one more freshman. Very quickly, however, Borden's classmates noticed something unusual about him and it wasn't his money. One of them wrote: "He came to college far ahead, spiritually, of any of us. He had already given his heart in full surrender to Christ and had really done it. We who were his classmates learned to lean on him and find in him a strength that was solid as a rock, just because of this settled purpose and consecration."2
During his college years, Bill Borden made one entry in his personal journal that defined what his classmates were seeing in him. That entry said simply: "Say 'no' to self and 'yes' to Jesus every time."3
Borden's first disappointment at Yale came when the university president spoke on the students' need of "having a fixed purpose." After hearing that speech, Borden wrote: "He neglected to say what our purpose should be, and where we should get the ability to persevere and the strength to resist temptations."4 Surveying the Yale faculty and much of the student body, Borden lamented what he saw as the end result of this empty philosophy: moral weakness and sin-ruined lives.
During his first semester at Yale, Borden started something that would transform campus life. One of his friends described how it happened: "It was well on in the first term when Bill and I began to pray together in the morning before breakfast. I cannot say positively whose suggestion it was, but I feel sure it must have originated with Bill. We had been meeting only a short time when a third student joined us and soon after a fourth. The time was spent in prayer after a brief reading of Scripture. Bill's handling of Scripture was helpful. . . . He would read to us from the Bible, show us something that God had promised and then proceed to claim the promise with assurance."5
Borden's small morning prayer group gave birth to a movement that spread across the campus. By the end of his first year, 150 freshman were meeting for weekly Bible study and prayer. By the time Bill Borden was a senior, one thousand of Yale's 1,300 students were meeting in such groups.
Borden made it his habit to seek out the most "incorrigible" students and try to bring them to salvation. "In his sophomore year we organized Bible study groups and divided up the class of 300 or more, each man interested taking a certain number, so that all might, if possible, be reached. The names were gone over one by one, and the question asked, 'Who will take this person?' When it came to someone thought to be a hard proposition, there would be an ominous pause. Nobody wanted the responsibility. Then Bill's voice would be heard, 'Put him down to me.'"6
Borden's outreach ministry was not confined to the Yale campus. He cared about widows and orphans and cripples. He rescued drunks from the streets of New Haven. To rehabilitate them, he founded the Yale Hope Mission. One of his friends wrote that he "might often be found in the lower parts of the city at night, on the street, in a cheap lodging house or some restaurant to which he had taken a poor hungry fellow to feed him, seeking to lead men to Christ."7
Borden's missionary call narrowed to the Muslim Kansu people in China. Once that goal was in sight, Borden never wavered. He also inspired his classmates to consider missionary service. One of them said: "He certainly was one of the strongest characters I have ever known, and he put backbone into the rest of us at college. There was real iron in him, and I always felt he was of the stuff martyrs were made of, and heroic missionaries of more modern times."8
Although he was a millionaire, Bill seemed to "realize always that he must be about his Father's business, and not wasting time in the pursuit of amusement."9 Although Borden refused to join a fraternity, "he did more with his classmates in his senior year than ever before." He presided over the huge student missionary conference held at Yale and served as president of the honor society Phi Beta Kappa.
Upon graduation from Yale, Borden turned down some high paying job offers. In his Bible, he wrote two more words: "No retreats."
William Borden went on to graduate work at Princeton Seminary in New Jersey. When he finished his studies at Princeton, he sailed for China. Because he was hoping to work with Muslims, he stopped first in Egypt to study Arabic. While there, he contracted spinal meningitis. Within a month, 25-year-old William Borden was dead.
When news of William Whiting Borden's death was cabled back to the U.S., the story was carried by nearly every American newspaper. "A wave of sorrow went round the world . . . Borden not only gave (away) his wealth, but himself, in a way so joyous and natural that it (seemed) a privilege rather than a sacrifice" wrote Mary Taylor in her introduction to his biography.10
Was Borden's untimely death a waste? Not in God's plan. Prior to his death, Borden had written two more words in his Bible. Underneath the words "No reserves" and "No retreats," he had written: "No regrets."

1Taylor, Mrs. Howard. Borden of Yale '09. Philadelphia: China Inland Mission, 1926, page 75.
2Ibid., page 98.
3Ibid., page 122.
4Ibid., page 90.
5Ibid., page 97.
6Ibid., page 150.
7Ibid., page 148.
8Ibid., page 149.
9Ibid., page 149.
10Ibid., page ix.

For more original content like this, visit: http://home.snu.edu/~hculbert

The day I saw true love

I remember one of the last shifts I worked in the little trauma step-down unit about 10 months ago. Patients there were still critical but did not require the intensive nursing care that the ICU demanded. Nevertheless, I’ve seen a number of patients deteriorate and die in that unit.

After my usual cruising into the department, finding a funny patient to joke around with and figuring out what needed to be done, I worked my way down to bed #9 which was a bit more private than the rest (it actually had a door). As I spoke with the nurse she explained what had happened to this young man—he had a tracheotomy so he couldn’t speak, and was recovering from major head and abdominal trauma following a serious car crash. He had been in the hospital for a few months now and was showing tremendous signs of improvement against all odds. As the nurse continue to give me the report on his condition, an incredibly attractive woman entered and entered the man’s room. The nurse said to me in hushed tones, “that’s his fiancé, she’s the reason he’s doing so well.” Intrigued by this statement, I stuck around a bit at the end of the unit. The nurse went on to describe the intensity at which she would visit: every day for the entire length of visiting hours…and sometimes the nurses would let her stay much longer because she was so helpful.

I was stocking supplies later on in the day and I saw her sitting on the side of his bed peacefully singing to him. I asked myself, “how do you do that? He can’t even talk to you—he hasn’t for months. Do you even know if he remembers you? He has a frontal lobe injury and his personality has changed, does that matter to you?”

Apparently not; for love does not consider those superficial characteristics.

What about the love shown to you by an infinite God?
Was it based on how you would react to God’s love?
Was it based on your choice of words?
Was it based on the emotion that you welled up inside yourself when you came to Him asking for forgiveness?
Was God thinking “oh, he must be truly sorry so I’ll love him!”?
No, it can’t be any of these, for it would debase God’s love to a level lower than this fiancé’s love for my patient. God’s love is so much higher and wiser than even the best expressions of love that we can construe. He loves us while we were “dead in our trespasses and sins”—he loves us when we can do nothing.

We think we know what love is all about, but we see it most clearly and for what it truly means when crisis arises.
It’s not some erotomania, it’s a God who comes to us as a human, He shows us the holes in his hands and feet and calls us to place our hands in his side. It’s not “I love you so I’ll give you a great feeling to live your life by.” Instead, He says, “Greater love has no man than this than that he lays down his life for his friends.” And He goes and submits an infinitely worthy life to the cross so that sinners like you and me can become the children of God. Our God is not all talk; he goes and does as much as it takes to know and love His own.

We love because he first loved us.

True Love Phil Wickham
Come close listen to the story
about a love more faithful than the morning
The Father gave his only Son just to save us

The earth was shaking in the dark
All creation felt the Fathers broken heart
tears were filling heavens eyes
The day that true love died, the day that true love died
When blood and water hit the ground
Walls we couldn’t move came crashing down
We were free and made alive
The day that true love died, The day that true love died

Search your hearts you know you can’t deny it
Lose your life just so you can find it
The Father gave his only son just to save us

Jesus is alive
He rose again

A letter to myself

Dear Jeremy,

It has probably been 5 or 6 years since you wrote this.  You're probably in the middle of a rough internship.  You haven't had a chance to update this blog for quite some time.  Your closest friends are your fellow interns you round with every morning.  Who knows when the last time you had the opportunity to go to church and when you did you fell asleep in the middle of it from exhaustion.  You're probably asking yourself "why did I ever choose this profession?" or saying "I never expected it to be this way."

I want to remind you of some things you said to yourself the night Springfest 2008 was canceled.  You said you had to go to bed, but then the wheels of inspiration started.  So I want to ask yourself some questions.  Remember back in the day when you were that immature 1st year medical student?  What has changed?

Do you still wake up in the morning and ask yourself "If today were the last day of my life would I do what I'm about to do today?"  How many times has the answer been "yes"?  What do you need to change to make it "yes"?

Do you still challenge yourself?  "Hey, listen up!  This is what matters most:  You're forgiven! You have hope! Your hope is based on the sacrifice of Jesus.  So let's not view this day any other way.  Let today be governed by this one defining truth."

Does this truth govern you when your senior resident is yelling at you?  Does it still govern you when you can't answer that question your attending asked you on rounds?

What did God tell you in His word today?  What does that look like today?  When your pager goes off as you're just about to fall asleep does His word still govern your response?

Have you gotten beyond the cross?  When was the last time you stood next to it, clung to it, promised you would never let it leave your side?  You've been here so many times before, you've stayed here for months and years at a time.  Jeremy, are you still at the top of Calvary with your eyes fixed on the cross?  If not, please come back.

Remember New Years 2008?  Remember when you took a walk through the crowds by yourself, made some decisions and sealed them in the heart of God?  You wanted to encourage others more.  Remember how it was so hard for the first few weeks and months after that decision?  Is it still hard?  Are you still trying?  Who did you encourage today?

Who did you pray with today?  Patients?  Remember when you prayed with Bob that lonely Monday evening in the hospital?  You had no idea what to say but God gave the words.  Do you love your patients with ways more than medicine?  Or are you too concerned with your own pursuits and getting enough sleep to show the love God so graciously showed to such a corrupted person as you?

I want to remind you of some reasons you chose to do this for the rest of your life.  You knew that a 9-5 job sitting in front of a computer would make you self-centered, materialistic, half-hearted 'Christian.'  

You knew that for you life to count, you would have to try to do something difficult and challenging because using your mind to the best of its abilities would glorify the God who meticulously arranges the nervous system.

You knew from experience that the times you were closest to the cross were when you felt the weight of so many hearts and lives on your shoulders.  

You knew that, "Unless a grain of wheat falls into the ground and dies, it remains alone, but if it dies it bears much fruit."  - Jesus.  Remember, martyrs are not made, they are revealed.

As I close maybe you're dealing with a situation that is totally out of your control.  You wanted to take charge but you failed again and again or you weren't allowed.  Maybe your patient keeps spiraling downward even though you're throwing everything at him?  Maybe those family members don't like you?  You're disappointed.  But God is in control.

Sometimes you have to keep trying.  Keep throwing everything you have at your patient and pray.

Sometimes you have to let go.  Yes, when your patient dies on the OR table,  in the trauma room, in the ICU, or in their comfortable bed at home it's over...they're never coming back in this life.  It's a good thing to remember and learn from, but it's over, there's nothing else you can do.

Other times when you have no idea what to do, you cling to that cross even harder.  He is there, even in the midst of uncertainty.  He made the world, he holds every atom in the place he ordains, he can place the universe easily into the palm of His hand.  And he still loves you.  Yes Jeremy, the creator of the universe in whose eyes you're are smaller than a speck of dusk, loves you.

Jeremy whatever you do never never stop showing love.  You have an infinite source of it from your Savior.  Give it all away, don't hold back some for yourself, it's not yours to hold on to.  I hope Jesus has grown your heart significantly in the past few years.  Don't be afraid to clip off pieces of it and give them away.  There's plenty more of God's heart at the cross for you.  He gave His heart freely so follow His example.

There are so many things I want to see in your life, but most of all I want to see that you've grown in your love for God.  The tangible way you can measure that is by seeing how you love others.  Go do it.

It's getting late and you probably need to get some sleep also.  May God bless you and keep you and make His face shine upon you and give you peace...the perfect peace of a life hidden in Christ.

By Grace,

Jeremy

Silence

It has happened to me more times than is worth remembering.  A sea of people clad in blue and green and white surrounding a stretcher.  Often some shouting and running around the room is involved.  There are all these machines up at the head of the stretcher.  They're flashing red and yellow and making all kinds of strange loud noises. There's someone who looks like they're jumping up and down on top of the person on the stretcher--sometimes I'm that person.  Everyone and everything is making noise--it's so loud.  A machine gets wheeled into the room, the jumping stops and a black and white image appears on the machine.  Someone says "I see no movement."  There's agreement among the sea of people.  Sometimes the jumping starts again for a while before it stops and they look at the screen again.  "No movement."  "Ok, any objections?"  "What's the time?"

Someone just died.

Suddenly the squawking ventilators and monitors are turned off.  The hissing of the suction and the oxygen cease.  The crowd of doctors, nurses, and technicians leave the room quietly.

And I'm left with another nurse, a white shroud, a closed door, and....silence.

But there is always one particular verse that has come to mind during those times.  Those times when I just want to do my job, wrap up the deceased, clean up the room, and move on to the next patient.

It's the same verse that came to Sydney Carton as he walked about the streets of Paris the night before he was to take Charles Darnay's place under the guillotine.

It's the same verse that came to me as I was moved to speak the gospel to an old and dying man not long ago.

I am thankful that I don't just hear this verse at funerals or when I get to the chapter in my Bible reading.  When all the sights and sounds fade away and all I'm left with is a dead body, a shroud, and someone to help, I'm often at a loss for words to say.  It seems that my theology goes down the drain while I ask "why?"  It's in the silence when the mind is grappling with reality that Jesus speaks the last word.

Jesus said..."I am the resurrection and the life.  He who believes in Me, though he may die, he shall live.  And whoever lives and believes in Me shall never die.  Do you believe this?"

What is He saying to you in the silence?

I was reminded this weekend of an article I read last summer about how Temple University is combating violence in North Philadelphia.  I've had the privilege to work alongside the surgeon who spearheaded this program.

"You have the rest of your lives to make decisions that will keep you from losing your lives around this [trauma] bay.  Don't put 15 minutes in the hands of our trauma surgeons and expect them to bring you back the life that you squandered."

Gripping

Relevant

Loving.

What about your soul?

Is it like that body lying on the gurney?  

Are you risking the loss of your own soul?  

What decisions will you make this week to keep you from losing your soul?

Don't think that you have the rest of your life to repent of those decisions.

"For what profit is it to a man if he gains the whole world, and loses his own soul?  Or what will a man give in exchange for his soul?"  Matthew 16:26

What are you exchanging for your soul?

Security?

Affluence?

Family?

Entertainment?

Where's your cross?  Pick it up and lets get going...

Good Friday

As much as I dislike the use of modern writings and drama to describe the events of the crucifixion, sometimes they help to add an element of reality.  If guided by the Word of God these alternate stories can help our minds wrap around its infinite meaning.

This one is rather old and contains unrealistic medical science fiction, but it certainly allowed me to implant myself into the story and capture the application.  I believe it was written specifically for Christians to combat our complacency.

Daddy

Children have great attachment for their primary caregivers. Typically they are "mommy" and "daddy." It's an expression of endearment and intimacy. Probably my most vivid memories of children crying "mommy" or "daddy" are when they're hurt or when mommy or daddy can't be found. When it's used as a cry, it displays a great dependence upon "mommy" or "daddy," a longing, a strong desire for their presence and their help.

The word "daddy" is used in the Bible. It's "Abba." It's used in three places. The first is when Jesus cries out in Gethsemane to let the cup of God's wrath pass from him.

“Abba, Father, all things are possible for You. Take this cup away from Me; nevertheless, not what I will, but what You will.” (Mark 14:36)

As the weight of taking upon the wrath of God poured began to sink heavily upon Him, Jesus cried out to His Father.

The other two uses of the word "daddy" are by Paul in his letter to the Romans and the Galatians. Both refer to our adoption into the family of God. Romans 8:14 speaks that as sons and daughters of God we are led by the Spirit of God. The Spirit also confirms that we are children of God (v. 16).
Galatians clarifies that a little bit more. The Spirit is sent into our hearts to enable us to cry with the same intimate, dependent voice "Abba, Father" (Galatians 4:6) Yes indeed, the God who justified and adopted us now sanctifies us from within, not from the outside, but from the heart...the organ that affects the entire body. He synchronizes our heartbeats with His so ours can thrive from the strength of His. From within us, the Spirit cries for deeper intimacy with our Father. His desires become ours and we are enabled by the Spirit of His Son to draw closer.

So this Easter season, look for ways the Spirit is crying in your heart "daddy." Don't ignore them, respond.

God's Heart

During a complete physical exam of the heart in addition to listening with a stethescope, one must feel for the point of maximal impulse (PMI).  The location of the PMI is typically at the apex or tip of the heart as it extends to the patient's left side.  Depending on the size of the patient and their heart the PMI may be difficult to find, but there's no doubt once you do.  On a healthy patient it's a strong and steady pounding.

It's hard to get to know someone's heart if they're not your patient.  You can't just walk up to any guy or girl on the street and ask to feel for their PMI (please don't try this).  Nor is it easy for someone's emotional heart to open up to you--it takes time, gentleness, and trust.

But here is a heart that is wide open, on exhibit.  You can touch, you can listen, you can experience this heart.  Thomas Goodwin wrote of it,  "The heart of Christ displays the heart of God.  Take your hand and put it on the breast of Christ...and you will find it racing at the sight of you."

The cross is the best display of God's heart; it is where you can feel his heart beat strongest.  

Passionately examine, study, and live God's heart.  

Oh to have that same heart beating in my chest!

Definitions

Definitions in medicine are very exact and complete.  Definitions of a tagged item during an anatomy practical exam are often:  "posterior circumflex humoral nerve," "superficial branch of the radial nerve," or "ascending branch of the lateral circumflex femoral artery."  A change or omission in any of these key words would completely change the definition.  I was fortunate to learn these definitions from some of the oldest and well spoken anatomy professors in the history of modern medicine as well as Netter's Atlas of Anatomy which is considered by many to be the bible of anatomy images.

So, where do you get the definition of your words from?  From pop culture?  From your friends, your professors, your church?  How accurate are those definitions?

There is one word that for the past few years has disturbed me: love.

The dictionary's definition:  

(n).  A deep, tender, ineffable feeling of affection and solicitude toward a person, such as that arising from kinship, recognition of attractive qualities, or a sense of underlying oneness; A feeling of intense desire and attraction toward a person with whom one is disposed to make a pair; The emotion of sex and romance; An intense emotional attachment, as for a pet or treasured object; A person who is the object of deep or intense affection or attraction; beloved. 

If love is ineffable then the only way to truly define love is to view its actions, not analyze the feelings.

God's definition:  In this is love, not that we loved God, but that He loved us and sent his Son to be the propitiation for our sins. (1 John 4:10)  God demonstrates His own love toward us, in that while we were still sinners, Christ died for us. (Romans 5:8) 

"See how I love you.  There is my Son, see Him hanging on that cross, naked, mocked, and tortured--taking your sin.  Look, the sky is dark, I have forsaken My Son, He's crying out to Me but I'm turning My ear away so that you can come into My presence.  Come, I just tore that thick curtain in the temple down.  You can freely come to me.  Sinner, look at Love.  Look at pierced hands.  Look at pierced feet.  Look at a pierced side.  Look, the Creator of life has died. Come close, look at Love."

I want that definition because it's not shallow or esoteric.  It's real.

"By this we know love, because He laid down His life for us.  And we also ought to lay down our lives for the brethren." (1 John 3:16)

Why do you live?

I've been reading "Shadow of the Almighty" by Elizabeth Elliot. Her late husband Jim wrote these words 7 years before being speared to death by the Waodani tribe in Ecuador:

"Overcome anything in the confidence of your union with Him, so that contemplating trial, enduring persecution or loneliness, you may know the blessedness of the 'joy set before,' for 'We are the sheep of His pasture. Enter into His gates with thanksgiving and into His courts with praise.' And what are sheep doing going into the gate? What is their purpose inside those courts? To bleat melodies and enjoy the company of the flock? No. Those sheep were headed for the alter. Their pasture feeding had been for one purpose: to test them and fatten them for bloody sacrifice. Give Him thanks, then, that you have been counted worthy of His alters. Enter into the work with praise."
- Jim Elliot (1949)

Cultivating a tender heart

I was going through some files this evening and I
pulled out a newspaper clipping I had copied from a few years ago. It's the scene of a tractor trailer that had overturned and closed the southbound highway for a few hours. Although I don't remember much about this case, I do remember the outcome: the driver walked out of the hospital with a broken scapula and a few minor cuts.


Sometimes I've wondered why I'm still alive. It's not unusual for me to be coming home from some event on a rainy day, suddenly the traffic slows, an ambulance and a cop speed by on the shoulder and I begin to wonder, "why did I leave 30 seconds later than I did?" "Why did that person come up and say 'hi' for a few seconds?" "Why did that driver cut me off?" "Why did I get stuck behind that truck?" And it's all to easy to pull off an exit earlier, cut a few more drivers off in my rush to get home, pull into my driveway, and start studying as if nothing had happened.

It's such an irreverent way to live.

Yesterday a 8 year old girl died in the NJ turnpike...just a small error in judgment, a nodding of the head, or a jerk of the wheel and a life was slammed into eternity. For some reason, these little blurbs always come on whenever I walk by the TV. Is it because I "just happen" to be walking by? Or is it for a very specific, defined reason? I submit to the latter.

As I wonder why I escape those accidents on the freeway I often think that God is keeping me alive for some reason, for some person, for something else He wants me to accomplish for him in this life. But it often never goes beyond those impressive events. For while I look for Him to speak to me in the exciting, tragic, or unusual events I encounter, I often fail to hear Him whispering to me.

Elijah after witnessing the victory of the Lord on Mt. Carmel goes into hiding in a cave from Jezebel. There God confronts him as to why he is in the cave. That call goes out to you today...what are you doing in the place where you are? Is it truly the place God has appointed you to be in, or are you hiding from His plan? Or, more importantly, what are you doing with the people, the opportunities, and responsibilities He has currently placed in your hands?

God then shows Himself to Elijah.

"Then He said, “Go out, and stand on the mountain before the LORD.” And behold, the LORD passed by, and a great and strong wind tore into the mountains and broke the rocks in pieces before the LORD, but the LORD was not in the wind; and after the wind an earthquake, but the LORD was not in the earthquake; and after the earthquake a fire, but the LORD was not in the fire; and after the fire a still small voice. So it was, when Elijah heard it, that he wrapped his face in his mantle and went out and stood in the entrance of the cave." (1 Kings 19:11-13)

Matthew Henry says, "Gracious souls are more affected by the tender mercies of the Lord, than by his terrors. The mild voice of Him who speaks from the cross, or the mercy-seat, is accompanied with peculiar power in taking possession of the heart."

Are you ignoring the small voice of God in your life while you search for the big, exciting, terrible, and powerful voice of God? Will you cultivate that tender soul that listens to that still small voice echoing from the blood stained cross saying, "Come, follow me"? And when your heart is cold and dull, and you miss what He's saying to you, He repeats it over again so you can hear. He wants you to hear His voice, He wants you to follow Him, He's calling out to you and me. What's Jesus telling you today? What words and thoughts has He been impressing upon your heart? In what way is He telling you this minute to love Him more?

I don't see accidents like the picture above every day, but yet how often I fail to miss the voice of God speaking into my life each day. Oh for a tender heart that stays close to the cross so that I may not miss that still small voice!

The "Look"

I was an 18 year old newbie in the ER of my small hometown hospital.  The triage nurse asked me to watch the desk as she stepped out for a minute.  Just then a woman in her 50s walked up to the desk asking to see a doctor.  She had a dull pain in her right arm.  I checked her vital signs (completely normal), hoping the triage nurse would walk back into the small cubicle.  I asked her a few more probing questions regarding her condition that lead to no good explanation of any underlying root cause.

Then I looked closely into her face and my heart began to sink.  I said to her, "I'm not sure what's wrong, but I'm going to take you to a room to make sure nothing serious is going on right now."  Something didn't look right about her, but I couldn't describe it.  I knew I was taking a chance with her, I had only one monitored bed left and that was in our resuscitation bay, I had a full waiting room with many complicated and serious cases, yet I was taking this calm woman with a low level of pain back to a huge treatment room.

Without waiting for her to undress, I stuck three wires on her chest and looked at the monitor. Within seconds I was yelling for a nurse and doctor as I hooked her up to an oxygen mask and other monitoring devices.  My suspicions were confirmed a minute later when I did an EKG: she was having a heart attack.  Thankfully, within a few minutes later she was whisked off to get a few stents placed in her coronary arteries and she lived.

How I knew that she was having a heart attack is still beyond me.  This same experience has happened a few times since then, but I have yet to be able to figure out the heart attack "look" even after discussing it with many of my colleagues who have witnessed the same.

Sometimes we often base the decisions in our lives upon impressions given by things, places, or other people.  But are experiences really true metrics that should guide the decisions we are constantly faced with?  Certainly they play a role, but are they sufficient?  It's not enough to trust the heart attack "look."  You still need the gold standard EKG and you still need the cardiology consult to accurately diagnose a heart attack.  One would think that the Apostle Paul who had a Damascus road experience with the living Christ would have sufficient proof of his calling to preach the Gospel to the Gentiles (Acts 26:14-18).  Yet, when he describes his calling to preach the Gospel in distant lands, he quotes Isaiah to authorize his calling (Romans 15:20-21).  The Apostle Peter (2 Peter 1:16-21) was an eyewitness of the transfiguration of Christ yet he calls the prophecy of Scripture given to us a "word made more sure, which you do well to heed as a light that shines in a dark place..."

Let us be encouraged that our salvation and our only hope in life is not based upon experiences but upon the rock solid truth of the word of God.  Our experiences and impressions will waver as we go through life.  Their passion waxes and wanes.  But the time tested truth of the word of God delivered by His Spirit never fails.  For "all Scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness, that the man of God may be complete, thoroughly equipped for every good work." (2 Timothy 3:16-17).

Spiritual kidneys

This is an image of some small arteries in the kidney. The large stalk is the interlobular artery which gives off afferent arterioles. The arterioles end at the round shaped "flowers" called glomeruli.

There are about 1 million "flowers" in each kidney and filter your blood at a grand total of 1800 liters per day.

Kidneys don't just filter blood, they make sure your electrolytes are perfectly in balance, they keep your blood pressure stable, and they make hormones to regulate it all.

If your kidneys fail there's a lot that can go wrong and you often have to be put on dialysis so you won't die.
These are physical kidneys, but there are also spiritual kidneys. Kidneys that examine the experiences, events, people, actions, events, thoughts, words, pictures, senses, etc. that enter our souls. That kidney is the conscience. It constantly convicts or otherwise encourages us in whatever we are doing...and it works constantly unless we shut it down.
Like the person with uncontrolled diabetes mellitus whose kidneys begin to fail, so it is with the person who continually indulges in sin. You never really notice it, because you've suppressed the effect of your conscience. But then something happens, and you realized that you have injured your conscience so much that it won't recover on its own without drastic measures.

Treatment for late stage diabetic nephropathy is ultimately dialysis and kidney transplantation. Sin has so damaged all of our consciences that life saving treatment can only be found in external sources, not popping self-help medications. Yes, we all need new kidneys. We all need a "righteous not of our own...but that which is through faith in Christ, the righteousness which is from God by faith..." (Philippians 3:9).

Christ has perfect kidneys, he lived a sinless life. He is willing to take your sin-ravaged failing kidneys and make them his own. He has plenty to give to you. Pray that you may receive them for they can never fail.

Two reasons why I'm in medicine

Craniotomy

(This is me opening my skull to give you access to my brain)

There are many reasons why I went into medicine.  But two will suffice for now.

The first is pretty selfish:  I love the atmosphere, the drama, the suspense, and the passion that abounds in medicine.  The doctors, nurses, support staff, and patients have an irresistible pull on me that I'm not sure I shall ever be able to let go.

The second is a little deeper, morbid, and carries more support:  I love death.  Note that I do not love when others die, but there is an intense experiential witness that it conveys to me.  This witness reminds me day after day, that this world is not all there is.  One day you too Jeremy will be lying cold on a stretcher.  You might be remembered by a tombstone for a while, but eventually your distant family will forget you ever existed.  The accomplishments in life may put your name on some building, instrument, or company.  But after a few hundred years few will know or even care about who you were.

My pastor when I was growing up burned in me a desire to carry with me throughout life an "eternal perspective."  And so, what did I choose as a profession:  one where I can camp out at the finish line and watch those runners as they finish their race.  Sure, there are specialties in medicine such as dermatology and cosmetic plastic surgery that don't involve these "weighty matters."  Those, my friends, are not for me.  The first day I watched someone die was 8 years ago.  It was sad, but beautiful.  Since then it has been a constant stream of men and women, from 14 months to 98 years, who have passed from this earth in my hands.  Every encounter comes as though I had never experienced it before.  It's new and different every time and I'm confident that with perspective, that the future shall preserve its uniqueness.

Some say they went into medicine to "help people" to "change the face of healthcare" to "make a lot of money" or "because I love working with people."  I submit that one of the reasons I went into medicine was to save my life from one of disillusionment, of false aggrandizement, of self-centered pleasure, and of self-glorification.  Yes, I needed to be reminded that a body that can run a marathon, hands that can delicately slide a needle into the vein of a 14 day old, and a mind that can comprehend the afterload of one myosin head will one day, perhaps very soon, arrive at death's door.

The apostle Paul wrote, "but what things were gain to me, these I have counted loss for Christ.  But indeed I also count all things loss for the excellence of the knowledge of Christ Jesus my Lord, for whom I suffered the loss of all things, and count them rubbish, that I may gain Christ and be found in Him, not having my own righteousness, which is from the law, but that which is through faith in Christ, the righteousness which is from God by faith; that I might know him and the power of His resurrection, and the fellowship of His sufferings, being conformed to His death if, by any means, I might attain to the resurrection from the dead."  (Philippians 3:7-11). 

This indeed is my prayer, that these verses might be worked out in my life that when I see others die, I am reminded of my own frailty and that I might count my life and the worthless things it produces as rubbish for the sake of knowing and serving Christ, trusting in Him alone for eternal righteousness.

So the next time you want to avoid death or run the opposite direction.  Consider your own death and Christ's call to bid us "come and die."  So, next time you have a chance to spend a few moments with someone who is about to slip beyond the curtain of this life, take the opportunity.  For it's hard to know what you are running towards if you never get a glimpse of the finish line.