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.