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)