Here it is, almost June, and it's been January since I contributed to my own blog. Excuses, excuses-- been gone to Haiti, on vacation for a few days, seeing patients, looking for a house to buy, trying to sell a house, and etc. Just not enough time to go around.
I'm glad that God doesn't run out of time. He invented time, and has the position of not being limited by it. Peter tells us in his second letter, "But do not forget this one thing, dear friends: With the Lord a day is like a thousand years, and a thousand years are like a day." To God, time is plastic. What we expect a thousand years to complete is an instantaneous process for Him. He is in the past, He is here now, He is in the future. He is above time. This is the essence of the Lord's statement of identity, "I am."
Because we are very time-limited creatures, we try to hold God to a clock. We look at the events of our own lives, and say to ourselves, "nothing's happening, God must be too busy." Not so. Not only is God involved in the big picture of the flow of time (His plan for creation, fall, redemption), but He is in the minutes, seconds, and microseconds of our every day.
Albert Einstein gives us a hand at understanding that time is plastic, even in the observable creation we live in. He theorized that for an object or person traveling faster and faster, time gets slower and slower. As the speed of light is approached, time for the traveler gets close to stopping. Science fiction writers let their characters travel to distant worlds, only to come home to find themselves as antiques.
I'm looking forward to the end of time. The scriptures tell is that it is coming, a day when we will stand in a timeless state, in an eternal now, around the throne of glory occupied by our Lord. I'll have plenty of time to write blogs then.
Sunday, May 30, 2010
Saturday, January 16, 2010
What happened in Haiti?
It's pretty difficult to not have heard about the awful earthquake that has struck Haiti, and the horrific loss of life and suffering. It would take a pretty cold heart not to be concerned, and not to want to do something to help. I hope that circumstances work out that I might get to help there, especially among the many there who are our brothers and sisters in Christ.
Why did the earthquake cause such death and destruction? On the simplest level, you can blame it on concrete buildings which were not built to withstand earthquakes. Concrete is a cheap and durable material for building in much of the world where wood gets eaten by termites in short order and steel is way too expensive. Concrete buildings can be built to be relatively earthquake resistant. So why weren't they?
Haiti is an example of a country whose culture is "event driven." This means that the perspective of life is to take care of what is necessary only in the very near future. My family and I lived in Belize for eight years, which has a similar cultural view. When events happen, they happen spontaneously, without very much planning. Throwing a party or church event? We'll start the preparations a few hours beforehand. Running late? No problem, it won't start until it starts, and an hour delay is perfectly OK.
Our country is more "schedule driven." This means that events are planned in great detail, months or years in advance. I know of churches who have already scheduled their missions conferences four years in advance, complete with venerated keynote speakers that may or may not live that long. Before the event starts, we'll make sure everybody's watch is coordinated so that there's no chance of awkward five second delay. Walk in late? Shame on you!
There are advantages and disadvantages to both societies. When living in Belize, I bit my nails to see so much brinkmanship in the planning of events and projects. But, they did get done, an the spontaneity was actually fun. In the U.S., we are so scripted that spontaneity makes us uncomfortable.
The difference between cultures gets amplified when there is a disaster. In the schedule driven society, there's a plan in place. Unlock the filing cabinet, look for the folder on what to do in case of Disaster X, and go for it. Heaven forbid that you don't have a plan, because when it's all over, you will no doubt get blamed. Witness the political blame-game that was the aftermath of Hurricane Katrina. Make sure that you rehearse the plans for Disaster X at least yearly. Don't worry if you don't really get much other work done, just make sure your disaster preparedness is up to snuff.
For the event driven society, a natural disaster gets response, but it's a spontaneous response. We went through several hurricanes and floods in Belize, and on every occasion the Belizeans stepped up to the plate to help out their neighbors in the immediate aftermath. Where they suffered was on the larger scale. Because it was perfectly OK to leave the roads unpaved because it was cheaper to occasionally smooth them with bulldozers, the dirt roads were sure to wash out and leave people stranded for weeks. It wouldn't make much sense to make your concrete house earthquake resistant... nobody's had an earthquake around here in a while.
I wish there were a happy medium. A society that was not too loose, not too rigid. A society that valued spontaneity, but was able to plan for the future. Maybe we'll get there one day when the Kingdom comes.
Why did the earthquake cause such death and destruction? On the simplest level, you can blame it on concrete buildings which were not built to withstand earthquakes. Concrete is a cheap and durable material for building in much of the world where wood gets eaten by termites in short order and steel is way too expensive. Concrete buildings can be built to be relatively earthquake resistant. So why weren't they?
Haiti is an example of a country whose culture is "event driven." This means that the perspective of life is to take care of what is necessary only in the very near future. My family and I lived in Belize for eight years, which has a similar cultural view. When events happen, they happen spontaneously, without very much planning. Throwing a party or church event? We'll start the preparations a few hours beforehand. Running late? No problem, it won't start until it starts, and an hour delay is perfectly OK.
Our country is more "schedule driven." This means that events are planned in great detail, months or years in advance. I know of churches who have already scheduled their missions conferences four years in advance, complete with venerated keynote speakers that may or may not live that long. Before the event starts, we'll make sure everybody's watch is coordinated so that there's no chance of awkward five second delay. Walk in late? Shame on you!
There are advantages and disadvantages to both societies. When living in Belize, I bit my nails to see so much brinkmanship in the planning of events and projects. But, they did get done, an the spontaneity was actually fun. In the U.S., we are so scripted that spontaneity makes us uncomfortable.
The difference between cultures gets amplified when there is a disaster. In the schedule driven society, there's a plan in place. Unlock the filing cabinet, look for the folder on what to do in case of Disaster X, and go for it. Heaven forbid that you don't have a plan, because when it's all over, you will no doubt get blamed. Witness the political blame-game that was the aftermath of Hurricane Katrina. Make sure that you rehearse the plans for Disaster X at least yearly. Don't worry if you don't really get much other work done, just make sure your disaster preparedness is up to snuff.
For the event driven society, a natural disaster gets response, but it's a spontaneous response. We went through several hurricanes and floods in Belize, and on every occasion the Belizeans stepped up to the plate to help out their neighbors in the immediate aftermath. Where they suffered was on the larger scale. Because it was perfectly OK to leave the roads unpaved because it was cheaper to occasionally smooth them with bulldozers, the dirt roads were sure to wash out and leave people stranded for weeks. It wouldn't make much sense to make your concrete house earthquake resistant... nobody's had an earthquake around here in a while.
I wish there were a happy medium. A society that was not too loose, not too rigid. A society that valued spontaneity, but was able to plan for the future. Maybe we'll get there one day when the Kingdom comes.
Wednesday, December 9, 2009
The Desolate Place
The Desolate Place
John and Elizabeth Sexton are different medical missionaries. They travel with teams to far-off places, as I do, but they focus on health education. The idea is to give our hosts overseas the knowledge they need to do their own medical care. Mission to the World medical teams travel to places that desperately need medical attention, so it is sensible to give our hosts the ability to carry on once we're gone. They have developed instructions that translate well into other cultures. Their classes are mixed with practical evangelism that the local churches can then use to reach out to their communities.
I caught up with John and Elizabeth at a Mission to the World medical meeting last week. The Sextons gave us an update, especially concerning their work at native American settlements. Where they work is a spiritual battlefield, where crime, violence, alcohol addiction and occultism intersect. Unemployment is reported at 80%. Churches there struggle to retain members and minister to wounded souls.
What's wrong at this community? Is the problem medical, sociological or spiritual? We don't help ourselves by putting problems in one box.. Rarely are such problems isolated. Medically, native Americans are more prone to problems of alcoholism and other forms of substance abuse. A neural reaction to alcohol produces a pleasurable state that leads to addiction. This can happen to anyone, but more frequently in native Americans. Historians cite alcohol addiction combined with smallpox for destroying native American culture in the 19th century.
Sociologically, addictive behavior leads to family dysfunction. The alcoholic and his family take on stereotypical roles, the alcoholic as a functional child, and others in the family as enablers of the alcoholic's behavior. Society as a whole suffers when there are so many holes in family structure, and children lack good parental role models. Government doesn't help when money is thrown around in the wrong directions, promoting dependency. Spiritually, the forces of darkness have a much easier time holding sway when Christians become discouraged from the constant bombardment.
The way out of this desolation is primarily spiritual. Yes, there are some medicines that slightly calm the cravings of the addicted brain. But no more effective treatment has been found than the overtly spiritual approach of Alcoholics Anonymous. Their twelve steps lead the alcoholic and the enabler into insight into the problem, repentance, and reliance on God. The best variations of these programs point toward Jesus Christ, whose walk to the cross brings transforming grace to the believer.
John and Elizabeth's strategy is to instruct families of younger children and teachers, helping them see a way out. The church plays a crucial role, as a safe haven and place for young people starved for role models to find them. The Sextons plan a trip in May of this year. If you're interested in helping, contact me at WSmithMd (at) aol (dot) com.
John and Elizabeth Sexton are different medical missionaries. They travel with teams to far-off places, as I do, but they focus on health education. The idea is to give our hosts overseas the knowledge they need to do their own medical care. Mission to the World medical teams travel to places that desperately need medical attention, so it is sensible to give our hosts the ability to carry on once we're gone. They have developed instructions that translate well into other cultures. Their classes are mixed with practical evangelism that the local churches can then use to reach out to their communities.
I caught up with John and Elizabeth at a Mission to the World medical meeting last week. The Sextons gave us an update, especially concerning their work at native American settlements. Where they work is a spiritual battlefield, where crime, violence, alcohol addiction and occultism intersect. Unemployment is reported at 80%. Churches there struggle to retain members and minister to wounded souls.
What's wrong at this community? Is the problem medical, sociological or spiritual? We don't help ourselves by putting problems in one box.. Rarely are such problems isolated. Medically, native Americans are more prone to problems of alcoholism and other forms of substance abuse. A neural reaction to alcohol produces a pleasurable state that leads to addiction. This can happen to anyone, but more frequently in native Americans. Historians cite alcohol addiction combined with smallpox for destroying native American culture in the 19th century.
Sociologically, addictive behavior leads to family dysfunction. The alcoholic and his family take on stereotypical roles, the alcoholic as a functional child, and others in the family as enablers of the alcoholic's behavior. Society as a whole suffers when there are so many holes in family structure, and children lack good parental role models. Government doesn't help when money is thrown around in the wrong directions, promoting dependency. Spiritually, the forces of darkness have a much easier time holding sway when Christians become discouraged from the constant bombardment.
The way out of this desolation is primarily spiritual. Yes, there are some medicines that slightly calm the cravings of the addicted brain. But no more effective treatment has been found than the overtly spiritual approach of Alcoholics Anonymous. Their twelve steps lead the alcoholic and the enabler into insight into the problem, repentance, and reliance on God. The best variations of these programs point toward Jesus Christ, whose walk to the cross brings transforming grace to the believer.
John and Elizabeth's strategy is to instruct families of younger children and teachers, helping them see a way out. The church plays a crucial role, as a safe haven and place for young people starved for role models to find them. The Sextons plan a trip in May of this year. If you're interested in helping, contact me at WSmithMd (at) aol (dot) com.
Sunday, November 22, 2009
Screwtape's New Deal
Yesterday the family and I trekked to Chattanooga to the gorgeous Tivoli Theater to watch Max McLean perform in "The Screwtape Letters." He did an admirable job of bringing C.S. Lewis's devil to life. Screwtape, the experienced temptor, advises an apprentice devil on techniques to bring a young Christian back into the pathway of the damned.
I read the book first when I was a teenager, and it make a lasting impression on me. Since then I've seen exactly how accurate Lewis's take on tempation has been. The enemy has literally tried every one in the book on me personally, especially the tempation to pride.
Watching Screwtape come to life made me ponder, from whence come temptations? Are they of external origin, or internal? The Biblical answer is yes, or both, because both are presented to us. Jesus was tempted in the wilderness by Satan, but James tells us we are led astray by our own evil desires (check James 1:13-14). Satan is not just a fairy-tale personification of badness, but a genuine, pernicious force. His influence on us comes by exploiting those persisting propensities to evil that remain within despite our new birth.
Lewis would need to add a new technique to Screwtape's bag of tricks if he were writing today. The magazines of pulp science, Discover in particular, make much these days of the technique of functional magnetic resonance imaging of the brain. This probing technique shows activity inside the cranium as thoughts flash here and there. A lustful thought, a racy picture causes flashes in one area, hatred in another. From this, we are told that our brains are built to perform these functions, and they're just manifestations of evolutionary biology. Thus, persistent pridefulness is actually good for us. I'm the best hunter in the forest.... I'll bring down that mastodon and feed the tribe single-handedly. We're just poor creatures who must follow the pathways of our neurons, and thus we're not really responsible for the destruction our sin produces.
To really understand what's going on, we have to go back. The problem is not our neural pathways, the problem is sin. Sin, brought forward through the ages from our original parents, has corrupted our bodies and brain, such that sin, which should immediately cause pain, instead causes pleasure. This aberration is, thankfully, subject to divine intervention in our lives today. A Christian's goal is to one day find that his thoughts are so controlled by the will of our Heavenly Father that even the remembrance of sin causes immediate recoil. Then Screwtape and his minions will be defeated.
I read the book first when I was a teenager, and it make a lasting impression on me. Since then I've seen exactly how accurate Lewis's take on tempation has been. The enemy has literally tried every one in the book on me personally, especially the tempation to pride.
Watching Screwtape come to life made me ponder, from whence come temptations? Are they of external origin, or internal? The Biblical answer is yes, or both, because both are presented to us. Jesus was tempted in the wilderness by Satan, but James tells us we are led astray by our own evil desires (check James 1:13-14). Satan is not just a fairy-tale personification of badness, but a genuine, pernicious force. His influence on us comes by exploiting those persisting propensities to evil that remain within despite our new birth.
Lewis would need to add a new technique to Screwtape's bag of tricks if he were writing today. The magazines of pulp science, Discover in particular, make much these days of the technique of functional magnetic resonance imaging of the brain. This probing technique shows activity inside the cranium as thoughts flash here and there. A lustful thought, a racy picture causes flashes in one area, hatred in another. From this, we are told that our brains are built to perform these functions, and they're just manifestations of evolutionary biology. Thus, persistent pridefulness is actually good for us. I'm the best hunter in the forest.... I'll bring down that mastodon and feed the tribe single-handedly. We're just poor creatures who must follow the pathways of our neurons, and thus we're not really responsible for the destruction our sin produces.
To really understand what's going on, we have to go back. The problem is not our neural pathways, the problem is sin. Sin, brought forward through the ages from our original parents, has corrupted our bodies and brain, such that sin, which should immediately cause pain, instead causes pleasure. This aberration is, thankfully, subject to divine intervention in our lives today. A Christian's goal is to one day find that his thoughts are so controlled by the will of our Heavenly Father that even the remembrance of sin causes immediate recoil. Then Screwtape and his minions will be defeated.
Tuesday, November 17, 2009
Adventures in surgery
This morning I entered the world of major surgery in a big way. My patient, named Andy, needed a major overhaul of his internal organs. In fact, his vital organs were all in need of replacement. I and my assistants, all second grade students, had to identify all the parts and put them back in Andy the doll. This was my job at a local elementary school health fair that I was invited to attend as a guest instructor. It was actually a lot of fun in that second graders are not spoiled yet and got pretty enthusiastic in our surgical undertaking. One delicate matter was explaining the function of intestines and kidneys and why we make trips to the bathroom on a regular basis.
This is probably as close as I'll ever get to being a real surgeon. In medical school, I felt very uncomfortable when asked to cut and sew. One determined surgeon tried to teach me how to fix hernias, which took me about two hours to complete. A good surgeon, such as the one who fixed my hernia a few years back, can do it in fifteen minutes. Since then, I've limited myself to skin-deep procedures, the "lumps and bumps."
This afternoon got a little more serious as I went out for house calls. One patient was a man of my same age who lives in a dilapidated mobile home a few miles from my comfortable home. I had met him at a health fair a week ago and had promised to visit him to address his high blood pressure. A lack of a job and health insurance had kept him away from medical care. As I examined him today, his wife was busy flattening out flour tortillas in their cramped but clean kitchen. My patient's blood pressure was about 30 points over the limit for both systolic and diastolic. More worrisome, he had an episode of one-sided facial drooping and muscular weakness last month that had resolved over several days. Although his muscles were strong today, abnormal reflexes on one side gave me the idea he had suffered a stroke. I pray that the two medicines I prescribed for him for his hypertension and an aspirin pill a day will keep him out of serious trouble. As I was leaving, his wife promised me some tortillas when I came back next week.
When I encounter a patient my same age with so many problems, it causes me to think about what Dr. Luke reports Jesus saying, "Everyone to whom much was given, of him much will be required." Why is that I have my health, many comforts, and employment doing something I enjoy, when my patient, who was created in God's image as much as I was, has not? I should be more diligent to use the talents that I have, not for fear that they will be withdrawn from me if I don't use them, but rather in gratitude for the grace that I have enjoyed.
This is probably as close as I'll ever get to being a real surgeon. In medical school, I felt very uncomfortable when asked to cut and sew. One determined surgeon tried to teach me how to fix hernias, which took me about two hours to complete. A good surgeon, such as the one who fixed my hernia a few years back, can do it in fifteen minutes. Since then, I've limited myself to skin-deep procedures, the "lumps and bumps."
This afternoon got a little more serious as I went out for house calls. One patient was a man of my same age who lives in a dilapidated mobile home a few miles from my comfortable home. I had met him at a health fair a week ago and had promised to visit him to address his high blood pressure. A lack of a job and health insurance had kept him away from medical care. As I examined him today, his wife was busy flattening out flour tortillas in their cramped but clean kitchen. My patient's blood pressure was about 30 points over the limit for both systolic and diastolic. More worrisome, he had an episode of one-sided facial drooping and muscular weakness last month that had resolved over several days. Although his muscles were strong today, abnormal reflexes on one side gave me the idea he had suffered a stroke. I pray that the two medicines I prescribed for him for his hypertension and an aspirin pill a day will keep him out of serious trouble. As I was leaving, his wife promised me some tortillas when I came back next week.
When I encounter a patient my same age with so many problems, it causes me to think about what Dr. Luke reports Jesus saying, "Everyone to whom much was given, of him much will be required." Why is that I have my health, many comforts, and employment doing something I enjoy, when my patient, who was created in God's image as much as I was, has not? I should be more diligent to use the talents that I have, not for fear that they will be withdrawn from me if I don't use them, but rather in gratitude for the grace that I have enjoyed.
Wednesday, November 4, 2009
The Professional Worrier
What makes folks go to the doctor? Something's not right, or there's something that makes you worry. Sometimes it's a pain signal coming from the body. Or, the knowledge of the presence of a silent disease. Or, just the worry that there might be something wrong.
What happens when we talk to the doctor? We feel better. We can relax a bit, knowing that someone more knowledgeable is on the case. Our doctor will pick up the ball and see what needs to be done. We've transferred our worry to the doctor.
In every society, there's a process by which problems and worries are mentally transferred to others. In Belize, where my family and I spent eight years, the process is most visible when there's a death in the family. With each death, one female relative becomes the designated "hysterical mourner." The rest of the family doesn't need to display tears or sorrows, especially the men. But one young to middle aged woman is expected to cry uncontrollably, faint, and make a scene. Predictably the hysterical mourner ended up being brought to my clinic so as to be given something to "calm her down."
American society tends to hire its worriers. Got a problem with someone else? Someone did you wrong? Hire a lawyer. Kids aren't making good grades? Hire a tutor.
Speaking from the other side, being a professional worrier isn't what doctors want to be. We'd rather play detective, teasing out that rare diagnosis. It doesn't really matter if that diagnosis has no cure, but we feel much better if we know what's going on. I recall a patient of mine with a constellation of strange aches and pains that I could never figure out. Listening to her was stressful. One day she started having internal bleeding. At last, relief. Something I can get to. Order a test, find her incurable esophageal cancer.
Doctors think they have two choices. They can internalize their patients' anxieties. This can last for a while, but tends to lead to burnout, which translates to the patient's perception that the doctor doesn't care. Or, they can become good actors, pretending to care but leaving their concern folded up in the patient's chart for another day.
Is there another choice for doctors when it comes to bearing other's burdens? Jesus said, "Come to me, all you who are weary and burdened, and I will give you rest." Our Savior is the only one who can really bear our patients' anxieties. I would have given up on medicine a long time ago without Him.
What happens when we talk to the doctor? We feel better. We can relax a bit, knowing that someone more knowledgeable is on the case. Our doctor will pick up the ball and see what needs to be done. We've transferred our worry to the doctor.
In every society, there's a process by which problems and worries are mentally transferred to others. In Belize, where my family and I spent eight years, the process is most visible when there's a death in the family. With each death, one female relative becomes the designated "hysterical mourner." The rest of the family doesn't need to display tears or sorrows, especially the men. But one young to middle aged woman is expected to cry uncontrollably, faint, and make a scene. Predictably the hysterical mourner ended up being brought to my clinic so as to be given something to "calm her down."
American society tends to hire its worriers. Got a problem with someone else? Someone did you wrong? Hire a lawyer. Kids aren't making good grades? Hire a tutor.
Speaking from the other side, being a professional worrier isn't what doctors want to be. We'd rather play detective, teasing out that rare diagnosis. It doesn't really matter if that diagnosis has no cure, but we feel much better if we know what's going on. I recall a patient of mine with a constellation of strange aches and pains that I could never figure out. Listening to her was stressful. One day she started having internal bleeding. At last, relief. Something I can get to. Order a test, find her incurable esophageal cancer.
Doctors think they have two choices. They can internalize their patients' anxieties. This can last for a while, but tends to lead to burnout, which translates to the patient's perception that the doctor doesn't care. Or, they can become good actors, pretending to care but leaving their concern folded up in the patient's chart for another day.
Is there another choice for doctors when it comes to bearing other's burdens? Jesus said, "Come to me, all you who are weary and burdened, and I will give you rest." Our Savior is the only one who can really bear our patients' anxieties. I would have given up on medicine a long time ago without Him.
Sunday, October 25, 2009
God's image
Why should anybody bother to practice medicine? When you think about it, even the best medicine available is just a stop-gap effort. Barring Christ's return, all my patients will die. So why bother?
One motivation is humanitarianism. You see suffering, you feel that as a fellow human being, you should do something to alleviate that suffering. No problem with that, but humanitarianism can only take you so far. When it's not convenient, or you've reached you "quota" of doing good, then self interest trumps humanitarianism.
Another motive is profit. People will give their last dollar to get well. Why not provide your patient a good service and expect to be paid sufficiently so that you can have a reasonable living? The problem is determining what is "reasonable." What standard should we use? American doctors have gained a reputation as being overly greedy, and overly flashy in their consumption.
For me, there can be only one absolute that keeps me going in medicine, especially missionary medicine. Each person on the face of this earth bears the image of the Creator. Says Genesis, God created us in His image. It may not be so obvious that this is true, because sin has highly degraded our physical and spiritual beings. What I am doing as a medical practitioner is to try to restore this image to its original glory. No, I can't accomplish this with pills and potions, but perhaps I can reverse or control a process of bodily decay, and perhaps my patient will recognize this as God's provision for them.
God's ultimate plan for His children is to restore them to the glorious state in which He created Adam and Eve. When, in the relatively rare situation, medicine completely cures a condition, this is a foretaste of what God is going to do in the complete restoration to come at Christ's appearing. I can't wait to be out of a job when He comes.
One motivation is humanitarianism. You see suffering, you feel that as a fellow human being, you should do something to alleviate that suffering. No problem with that, but humanitarianism can only take you so far. When it's not convenient, or you've reached you "quota" of doing good, then self interest trumps humanitarianism.
Another motive is profit. People will give their last dollar to get well. Why not provide your patient a good service and expect to be paid sufficiently so that you can have a reasonable living? The problem is determining what is "reasonable." What standard should we use? American doctors have gained a reputation as being overly greedy, and overly flashy in their consumption.
For me, there can be only one absolute that keeps me going in medicine, especially missionary medicine. Each person on the face of this earth bears the image of the Creator. Says Genesis, God created us in His image. It may not be so obvious that this is true, because sin has highly degraded our physical and spiritual beings. What I am doing as a medical practitioner is to try to restore this image to its original glory. No, I can't accomplish this with pills and potions, but perhaps I can reverse or control a process of bodily decay, and perhaps my patient will recognize this as God's provision for them.
God's ultimate plan for His children is to restore them to the glorious state in which He created Adam and Eve. When, in the relatively rare situation, medicine completely cures a condition, this is a foretaste of what God is going to do in the complete restoration to come at Christ's appearing. I can't wait to be out of a job when He comes.
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