When the truth hurts, trust builds

We got away with a mistake. A baby came in for his first visit. He was 4 days old and had been home for 2 days. And he was yellow. Really yellow. Put a chiquita sticker on that kid yellow. I sent him to the hospital lab to get a bilirubin level drawn (bilirubin is what causes jaundice. At too high of a level brain damage is possible.)

Every other time I have done this I have instructed the parents to call me if they did not hear a result in 2 hours. This time I didn't. When the results came back 2 hours later, my receptionist, instead of notifying me of the lab's phone call telling me the level was very high, just put the lab results in my inbox.

Since we are an electronic office, my paper inbox is the last thing I look at. On this day I rushed to an evening meeting and did not see the results until I came in the next morning. When I saw the results I was worried and upset. Worried because the child had not been treated in 20 hours, upset because I could not believe the lab had not called me. I asked my staff to call the mom every 30 minutes until we got a hold of her so she could take the baby in for treatment.

My receptionist could have remained silent, and allowed the lab to take the blame. I would have never known. While I was blaming myself for not asking the parents to call back, she spoke up and said that it was her fault, that the lab had called and she had not notified me as she should have.

I was touched by her honesty, and her character.

I did not beat her up over the mistake as I was pretty sure she would beat herself up pretty well on her own.

I did wonder how many people would have been as forthright. Telling the truth when the truth has consequences displays character that is all to rare, but it builds trust that endures.

When it was all over I was left with a healthy patient whose bilirubin had normalized and a healthy respect for my receptionist.

Lessons from a "normal" 18 year-old

Apparently I am naïve. I was recently informed that all 18 year-olds drink alcohol, and that getting inebriated 3-4 times a week is perfectly normal behavior. The individual educating me in this regard was somewhat of an expert on the subject, (if expertise is defined as being an 18 year-old who gets drunk 3-4 times a week- as opposed to the expertise acquired via 12 years of advanced training and 20 years of medical practice!)

I was particularly saddened by the cultural value this young person expressed. That belief that “common” and “normal” mean the same thing. Further, that “normal” means acceptable. I challenged her position with simple statement- “You can do better.”

It is easy to mock her positions as absurd, but I wonder if we all don't apply her logic at times. If “everyone” does something, we feel less guilty, more accepting of our actions. Men who regularly view pornography, women who complain about their husbands, people who spend money they don't have on things they don't need- can all be tempted to say “I'm not that bad, everyone does it.” The truth usually is that not everyone does, and even if they do, that is not the standard we should set. Instead of justifying our bad behaviors, we all need to ask ourselves, “can I do better?”

Can't we all? Shouldn't we all? We need to resist the temptation to justify ourselves by comparing ourselves to others. The Bible actually says that God demands the opposite from His people, “Be Holy, for I am Holy” scripture declares. “Holy” means distinct, separate, different. Our standards should be higher than those around us, our behavior should set us apart. Let's stop acting like average is okay and instead ask God to show us each day how we can be better, how we can be different, how we can be more like Him.

New, and anxious

She was new. It was her first visit in my office, her first time seeing any doctor since she had moved to California 4 months ago. Truthfully, she should have come much sooner, for her problem had been going on for quite some time.

She suffered from a pretty severe case of anxiety disorder which, when combined with panic, depression, three children and some OCD added up to more than most people can handle.

The diagnosis was easy, more of me confirming what she knew to be true rather than solving a dilemma. The treatment decisions were pretty easy as well, as it really didn't matter which flavor of prozac-like medication I chose. The biggest challenge was getting her to believe that she would be okay, that normalcy was a possibility.

Since all she knew about me was that I had decent Yelp reviews, I felt it appropriate to give her a better basis for confidence in my recommendations. I briefly shared with her that I have experienced many of the same symptoms, and the same diagnosis. I have had anxiety and panic disorder for several years.

I then shared something else, something I pray hit home. I shared my belief as a Christian that we are all broken in some way. Every one of us. We all need help. And I shared that according to the Apostle Paul, God's plan is that we help each other, or as he put it, “We are to bear one another's burdens, and thereby fulfill the law of Christ.”

I was not surprised to learn that she was lacking such support in her life, that she was not part of any community of people who could love and encourage her. We talked about where she might find this support, and I encouraged her to consider checking out a local church, because a group of people who would care about her and pray for her could only be a good thing.

I told her to see me in a week, and to call me if she needed me before then. I then gave her a hug when she left. (Which may have been the best medicine I gave her) We too often forget the power of a touch, the impact of truly caring about someone. She reminded me of how much we all need that at times.

Avoiding Empty Thoughts

I have been chewing on an idea for a sermon series for a while, based on Ephesians 4:17. “So I tell you this, and insist on it in the Lord, that you must no longer live as the Gentiles do, in the futility of their thinking.” NIV (I say “chewing on” instead of “working on” because I do not at the moment have any preaching opportunities on the calendar)

Paul seems pretty adamant that there is a way we lived prior to coming to faith that we are obligated to stop, and that this way of living is characterized as “futile thinking”. An interesting term, a term made more interesting by looking it up in a Greek dictionary, where I learned it means “nothingness”, “useless” or “transitory”. Hmm. So Gentiles think about temporary things that amount to nothing, and we are supposed to be different. The remainder of Ephesians 4 lays out these differences, which may someday be the sermon series. Or a rather verbose series of Blog posts.

One result of all of this mastication is a greater awareness of how much “nothing” there is in the minds of people I converse with. So often things that matter so little end up mattering so much to so many people.

I think of conversations I have with young people about their future plans. Almost without exception their life goals focus on the accumulation of material wealth. We should be different, and markedly so. We should be focused on things that last, and no material thing endures.

It is worth noting that Paul would have told the Ephesians to avoid this type of thinking unless there was a significant chance that they might end up thinking that way! I am sure share the same tendency to wrong thought, and the same need to expend effort in thinking correctly.

A great question to ponder is, “How would my live be different if I truly thought of eternal and important things, if I saw the world as God does?”

Welcome To The Blog

Being a Family Physician means I am uniquely blessed. Everyday of my life I have opportunities to help people. Sometimes with medicines, sometimes with my hands, frequently with my words, for people do not come in with just physical needs. They come with spiritual and emotional needs as well. As a Christian who has studied the Bible for years, I have learned that if I pay attention- if I listen carefully, I can see the truths of Scripture played out in their lives, and apply the truths of God to help them along their way. Usually, the interactions teach me as well.

Over the years, these interactions have become a part of stories around the dinner table, illustrations for sermons and conversations with friends. A recurring refrain as of late is that these stories should be shared, that others could be blessed if these stories were more widely shared. But how? Well apparently there is this thing called the internet, where you can write your stories and people all over the world can read them! So hear we are. I pray that some will find these stories a blessing, and that I am correctly responding to the quiet voice in my head and heart urging me to write.

Speaking of quiet voices... when I first went into medial practice, my partner called me aside one day and told me, “Bart, listen to your gut. It will save lives.” He was right.

Last week a patient came in complaining of soreness in her hip and right leg. She had a history of back pain in the past, and she said she felt as if the pain was burning in nature (which is usually a pinched nerve). As we talked she shared that the pain had been going on for about 10 days, and had started after she had flown home from out of state.

Since the pain she described sounded radicular (doctor talk for “from a nerve in the back”) I proceeded to do an exam for back pain. Her back was non tender, and her strength and reflexes were all normal. I do not always have back patients lie down so I can check if they have pain when I raise a leg, but I did this time. No pain.

Then came the gut, the little voice- “check her legs.” So I did. I started feeling around her legs for any tenderness. The “Ow!” came as I felt in her upper calf. This was unexpected...

The conversation in my head began-

“Could she have a blood clot in her calf?”

“No- it has been 10 days!'

“But she was on an airplane!”

“But it was a short flight!”

The debate raged in my mind. Finally, I decided to listen to that voice of concern in my head, the uneasiness in my gut. I told her I doubted that it was serious, but that there was a small chance that there could be a blood clot in her leg, and so to be safe I was going to order an ultrasound.

Sure enough... she had a blood clot.

In thinking about her case, and in other cases where gut feelings and quiet voices have made a difference, I am reminded of how God “speaks” to us. At least for me, I do not hear an audible voice giving me guidance. Instead, there is a sense in my spirit, a quiet voice, urging me in the right direction. (Sadly, it seems that often it is a voice urging me not to go in the direction I am heading!)

And just as my partner taught me in medicine, I do well to train myself to hear that voice, to pay attention to it and not dismiss it. It may not always make sense, it often will suggest a seemingly more difficult way, but “listening” to God's leading can prevent a world mistakes and pain!