Wednesday, August 21, 2013

The Psalmist's Sieve

The Christian life is not a life to be only contemplated, it is a life to be lived. What does that look like? Lived in the midst of joy, delight, suffering and sorrow, with a thousand frustrations along the way. Sometimes I think, usually only upon reaching the end of myself, how I need to reframe my thoughts to align with God’s plans and purposes. He isn’t sitting in Heaven frustrated, irritated, and with vision blurry from anger. And yet, where I am right now, there is injustice, poverty, oppression, apathy, disease, pride, and death. The stench of those foul odors waft through life here every day.

Too often, though, we find ourselves fighting against them with a very human strength. Unfortunately, disease and sorrow and poverty are winning. There are times when we can alleviate a small drop of them, but one drop isn’t even noticed when it is removed from the sea. Our frustrations will have only mountains more to add to their burdens, unless we learn to let go a bit. When I say “let go”, I don’t mean become lazy or apathetic. I mean filter properly.

It is God who allows us to make a small difference, to bring a brighter moment to someone’s day, a smile to their face, restoration in the midst of decay. And it is God who, for now, allows the vast majority of those dark evils to remain. Even after healing, the body still heads toward death. Even great joys will have times of sorrow to follow.

Big things, little things, they start to build up and wear us down. The frustrations of living as a plain, normal human. Just like for you. The kids don’t quiet down to give you a moment to avoid the snap of your temper. Your spouse doesn’t even try to see it your way. The neighbor’s dog poops in your yard, not once, but every single day. You get overlooked at work, while others get acknowledged and don’t even deserve it. Your relationships are falling apart. He died. She died. They left. Don’t have enough to make the bills. On and on.

This is real life. And yet, in the middle of it, there is real hope. In every joy and sorrow, I want to grasp them each up and run to the Lord with them. Like the Psalmists, pouring out their hopes, praises, losses, pains to the God who truly does care. Those men had a perspective of God that was big enough for them to take their troubles to, kind enough to be willing to help bear them. They knew Him as the only one great enough to worship, and the one worthy of continual praise. So they brought Him their greatest and worst moments, and left them there for Him to make sense of. He is the filter that I want to sieve through as well. Too often, instead I run to someone who can listen to me vent, knowing that they will be on my side. Then I can have the feeling that they understand. There is validity in that sometimes. But they aren’t my comfort, or shelter, or peace, or shield – God is. And He certainly understands better – not only my situation, but how it fits in His bigger plan.  I want to learn how to run much more quickly to Him. To give Him the burdens that are bigger than me, the sorrows that can overwhelm me, and the praise that flows from inside me, and let Him sort out the details. He is big enough to manage all of that.

Monday, August 5, 2013

The Splash

I knew that she was HIV positive before I started her surgery. I’d seen her multiple times for significant other problems related to her pregnancy. She was kind, and smiled sweetly each time she came to see me. But this last time was different. She was bleeding too much and I knew that a C-section would be needed urgently. I put on my routine  garb –hat, glasses, mask, plastic gown, then cloth gown, followed by double layers of gloves. I moved quickly, as the situation required. The placenta was sitting beneath where I had to cut the uterus to get inside to where the baby was, so I had to cut through the placenta. This added a little bit of extra bloodiness to the routine operation. As I finally got inside where I needed to be, I stretched my hands to make room to get the baby out. The tissues started to move against the force of my hands, and the amniotic fluid rushed out. In that moment a mixture of blood and amniotic fluid gushed at my head, hit my hat, mask, and glasses, went behind them, and ran all down the side of my face. I tasted the slightly salty (unfortunately previously known) taste of the fluid as it even soaked through my mask. There was nothing else to do but get the baby out quickly. Meanwhile, the fluid had also gotten all over my assistant and the anesthesia staff too, and they had immediately left the room to clean up. So, I found myself alone, with no one to hand the baby off to at the baby warmer. I was yelling for someone to come in and clean off my face, but it was multiple minutes before anyone arrived.

Finally a replacement anesthestist arrived at the head of the bed. He cleaned my face with rubbing alcohol. I told him that I needed to rinse out my eye. A moment later the bore of a needle was aimed at my left eyeball. I usually think it is a bit ridiculous to be scared by a needle, but this one was looking huge! It was equivalent to looking down the barrel of a shotgun pointed at your head. It was like a centimeter away and the more I looked at it, the bigger it got. I thought the guy was going to pierce my eye with it. I instinctively began to back away. He saw my deep distrust. He told me to be still and started to squirt sterile saline forcefully into my eye. I’d never exactly had an eye rinse like that one. It was scary. He finished a couple syringes full and then I finished up the surgery. 

After the case, I rinsed it more myself in the sink, grabbed the medications that are recommended for HIV exposure, and then went home to take a shower. Yuck. But the yuckiness was just beginning. I took the necessary pills upon arrival to my house. They were quite large, what in my family we would describe as “horse pills”. Almost immediately after taking them I felt some uncomfortable nausea. I figured if I just waited, it would go away. Nope, that wasn’t an accurate assumption. My compassion rapidly began to grow for those on such medications permanently. The nausea was constant, initially only relieved when I fell asleep at night. In addition, frequent diarrhea left me nervous to leave the house. I felt bloated up like one of the dead frogs that I used to find in the swimming pool. Disgusting, that is how it felt, disgusting. I spoke to others who had to be on the medications before for similar exposure related risk reductions, and they all said it had been awful. Most had stopped the medications after only a day or two because they felt so bad that they couldn’t leave the house.

I knew that my true risk for contracting the disease from the eye splash was really low, but each time I thought of stopping the meds I considered how stupid I’d feel if I were that rare person who contracted the virus and it could have been avoided. So, I kept on. I never really felt motivated by fear, just by a desire to do what seemed to be the responsible thing for my health. I did consider the obvious, of course, that it would sure stink to get that infection. But a moment later, the less obvious, but completely certain reality set in – that God can manage any “complication” that my life ever brings. That includes every single sickness and injury and pain and loss. I don’t have to live in dread of something bad happening. I don’t have to live with fear of losing control over part of my life. All I have to do is live for the glory of God. It is so comforting to know that He can handle all of the details from there. Now that doesn’t mean that I understand what He does with all of it, but I know that He can be trusted with whatever comes. And that is good enough.

Practically, I am very thankful, as I have now finished those terrible medicines. All my labs are fine, with negative test results for HIV. And I have once again been reminded that being in God’s hands is the safest place to ever be, regardless of circumstance. 

Thursday, August 1, 2013

Abdominal Pregnancy

Abdominal pregnancy. It's a very rare event that happens when the baby grows inside the abdomen, where all the guts and such are, instead of inside the uterus, where it should reside. It was one of those thoughts that always made my heart beat fast. What would it be like? Would the baby just hop out at me when I cut into the belly wall? The theory of coming across that obstetric rarity had always been sort of fearfully exciting. But as I stood there alone with the knife in my hand, there was no sense of excitement or adventure. There was only a very real sense that this patient could die in the next few minutes. She is alive right now, and she may be dead before she gets off the table. But there was no other choice.

I had called the surgeon on call with a fury of need and hope in the moments before scrubbing in to begin the case. But his phone wasn’t passing through. I had notified security to go to his house to get him, but he hadn’t come yet. I took a moment to pray my usual prayer for wisdom and skill and set my mind to act. I began to open the belly wall and found what I knew was a couple of cell layers away from disaster. I asked the anesthetist at the head of the table to call the surgeon one more time. I prayed that he would answer, and he did.  I waited, thankful that someone experienced with such possible complications was going to stand on the other side of the bed. He scrubbed in a few minutes later, and after seeing the mass, said that he had never seen something like this. If the mood were different I would have chuckled, since I was banking on his prior experience. The entire abdominal area was covered by the placenta, bearing its huge vessels boastfully before our eyes. If we got into those, the bleeding may not be controllable. The mass was attached to bowel from what we could initially see, and who knew what it was attached to beneath the superficial area of our vision. We found an area that seemed a bit thinner than the placental bed and opened it there. A gush of blood and fluid flooded out. I grabbed the baby’s feet and delivered it through the small incision that I had made. As we cleared all of the residual blood and debris, I noticed the importance of the exact area where we had entered. One inch higher and we would have injured the intestines, one inch lower and we would have been in the bloody placental bed. Indeed, God had guided our hands, just as I had prayed. After we could examine inside, it was clear that the possibility for catastrophe was even larger than we had known. The placenta had implanted itself in the large intestine, bladder, abdominal wall, and the kidney. How it spread to involve all of those organs was almost incomprehensible. But it certainly did. Removing it would endanger her life within minutes, so we packed some sponges inside to hold pressure and closed the belly up.

A day and a half later we opened her back up to remove the sponges. The surgery went well. She was in pain afterward, but overall was beginning to improve. I counseled her each morning on what the experts from the States had recommended for her further care. I prayed for her at night as I knelt on my bed. Last night as I prayed for her, all I could think about was making sure that she understood the Gospel. I determined to make sure to talk to her about it in the morning. But morning came and I again told her more about her condition and the treatment needed. She has so many possible complications and she had questions about each. I got lost in the medicine. It was evening as I read my Bible that I remembered that the one thing that I had set out to do for the day had been forgotten. I had covered the medical scene, but I had forgotten to make known the Gospel. Huh? I mean, am I a missionary doctor or what? Well, it turns out that I’m the very same doctor that I’ve been all along. How could I forget to mention the One I adore? Well, sometimes I get caught up in medical care and forget that something bigger needs to be addressed. It’s deep down in her eyes, past her figure, beyond her smile or frown, unseen and yet very real. Medical need is important, don’t get me wrong. The compassion to a patient through hands on care adds legitimacy to the claim that they actually are loved and cared for, that they have worth. But there is one weighty thing, and comparatively, the rest is feather light. And that is the truth of God’s love, poured out to us through the life and death of Christ. We call it the Gospel.

We all are sometimes carried away. Sometimes it’s by important things. Sometimes by just wasted time. We lose our focus and forget our purpose. We walk through hours, and days, and weeks like that. But people need to know that there is a God who loves them and who cares about what they are going through.

So, I walked back up there tonight to tell her about the goodness of the Lord. I’m no orator. I’m clumsy and stumble over my words sometimes. But I just started to tell her that God loved her enough to send His Son to make a way for her to be right in her relationship with Him. And that He cares about what she is going through now. The bad pregnancy, the possible complications, the treatments. He loves her, and He cares. I want her to rest tonight reminded of His great love for her in the midst of uncertain circumstances.

To those who read this, I want to remind you of His great love. All of life seems uncertain, but the Gospel allows us to rest in Him. He loves you and He cares.