Do you feel this Important Symptom of a Diseased Spiritual Heart?

Symptoms are important. They tell the patient that something is wrong and when properly understood can tell the physician what that something is. Every once in a while I get surprised by someone who is much sicker or worse off than I imagined. I find myself asking, “How is it they didn't feel this?”

I think of a 10-year-old girl who came to my office several years ago. She had fallen off of the monkey bars a few days earlier and had occasionally complained of arm pain. Her mother was only a little concerned but brought her in to see me just to be sure she was okay.

I examined the child, poking and prodding and moving her arm and shoulder all around. Not a peep or a grimace of pain. Her exam was perfectly normal. I told the mom I could not make a good argument for getting an x-ray, but gave an order for arm and shoulder films just in case. I told her to get the x-rays done if she was not better in 2-3 days.

Three days later they were back. The girl still was relatively asymptomatic, but this time one thing was different. This time she brought an x-ray of her upper arm that showed the humerus was broken. IN TWO! Snapped. Completely broken with the bones a centimeter apart. To this day I cannot understand how she could have slept comfortably, much less allow a doctor to move the arm over her head. It is hard to recognize a problem when there are no symptoms!

Our society is in a similar circumstance right now. We have serious problems, but many people do not feel or recognize them at all. They are missing something crucial that would allow them to understand how sick they really are.

Ravi Zacharias, a brilliant and articulate Christian leader, described the problem perfectly in two recent Facebook posts-

“To raise a child without shame is to raise one with no immune system against evil.”

“Shame is to the moral health of a society what pain is to the body. The sense of shame provides an indicator to the mind.”

Dysfunction is spreading through our culture, spreading because people lack a key means of recognizing it and dealing with it. They have lost a sense of shame. People are openly proud about behaviors which were once (and still should be) considered shameful.

I can think of many examples, such as the young man who came into my office for a check up, and when I asked about his sexual history, proudly declared that he was sexually involved with several girlfriends at the same time. Taken aback by his unabashed boasting, I clarified his response, asking, “So you are not saying you have had multiple partners in the past, you are saying that you currently have multiple women you are sleeping with?”

He extended his fist to give me a knuckle punch as he laughed and turned the word “Yeah” into one of three syllables. “Yea-a-ah, dude!” He had no shame.

I have seen similar sentiments expressed on Facebook, in blog posts and on television. Casual sexual encounters, vulgar language and other immoral behaviors are displayed as badges of honor instead of markers of shame. It seems that our world has fully embraced the view that no behavior is inherently wrong. If it feels good and brings pleasure in the moment it should be proclaimed and celebrated.

The freedom promised by the shameless pursuit of pleasure is false freedom, as it traps people in lives where it is impossible to experience the joy and peace that come from living life as God intends. Instead of running from and denouncing shame and embarrassment, we should train ourselves to cultivate a healthy sense of shame that will sound the alarm when we foolishly go our own way.

God wants to heal our diseased hearts, and appropriate shame can lead us to seek the cure. Ask yourself- "Do I feel the symptoms of my sinful heart, or am I becoming hardened to shame?" The answer is important.

Answers to Questions about Disciplining a Child

Being a parent is hard. Kids don"t come with instructions, a warranty or a return policy. Almost always they are raised by people who feel completely incapable of successful parenting. They want to raise happy, well adjusted and well behaved children but frequently find themselves with offspring who are anything but. What can they do?

Children need discipline, but in my experience most parents are ill informed about why, when and how to apply it. Since I have had hundreds of conversations on the subject over 20 years of medical practice, it seems appropriate to share some of the answers to discipline questions I have been asked over the years.

Question- When should we start disciplining our child?

Answer- When your child starts to do something, stops and looks to see if you are watching and then does it anyway, they are ready for discipline! Children vary developmentally but this usually happens by age one.

Question- Why should I discipline a child? (okay, so no one ever really asked this question specifically, but I have encountered a LOT of parents who needed to,hear the answer.)

Answer- Children are not naturally good. If left to themselves they will grow up to be selfish, disrespectful people who will struggle with relationships and authority. Don't believe me? Watch a young child for a while and you will see a child who has never been hit and never seen anyone be hit strike another 3 year-old who took his toy. It is in their nature.
Answer part 2- Discipline builds self esteem. How? Self esteem comes from knowing you are a good person. What do good people do? Good things and not bad things! Well established boundaries help a child know what good and bad are. This allows them to know when they are being good and then to feel good about it.

Question- What behaviors do we discipline?

Answer- Those that are rebellious or dangerous. Children need to be free to explore and express themselves without needless fear. A mom was in my office with her 2 year-old recently. The little girl wandered around the exam room playing with toys and opening cabinets. She opened the door on the changing table in the room, found a stack of diapers and took one out. The mom thought this was a learning opportunity and told the girl, "No! Put it back!" the daughter just stood there, and the mom repeated the command two more times before I interrupted.

"I wouldn't fight this battle," I said, "She is two and picked up a diaper. I would just take the diaper and put it back and be done with it." The girl had not done anything wrong and setting up the possibility of conflict made no sense. It is important to pick the appropriate battles.

Question- How do we discipline? Is it okay to spank?
Answer- Coming in a future blog post... :-)

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Someone You Know may have this Serious Disease...

It is my professional opinion that there is an epidemic in this country, an epidemic that has been ignored for far too long. The disease is widespread, afflicting a large number of goodhearted and kind people. If not diagnosed and treated it can lead to damaged relationships, isolation and stagnation. Sadly, most cases go unrecognized. The disease can affect all people but is most commonly seen in those in leadership or positions of authority. Parents, doctors and pastors are among those commonly afflicted.

The disease- Goodintentionitis. A disease where good intentions can result in bad behavior. There are two major symptoms of Goodintentionitis. There are secondary signs as well, but the diagnosis can be made when at least one of the major symptoms is present.

Major Symptom 1- Failure to follow up and follow through. In the early stages of the disease this takes on the appearance of forgetfulness, as people will "forget" to call when promised, or miss deadlines. An example of the early stages is when, at a meeting a someone says, "Let's discuss this again in a month." The month passes without any communication. Another example- someone says, “I will have this done for you next week.” A week goes by and nothing is said.
As the disease advances, failed follow up becomes more severe. Repeated emails are ignored and phone calls are not returned. I once expressed interest in returning to speak at a church where I thought I had been well received. My first inquiry was met with a response, "Send me your schedule and I will get back to you in a week." After two months I sent a follow up email, then another and another. It took 6 months to hear back. Similarly, I have seen physicians promise to submit a referral for a patient or investigate a problem for a patient, only to ignore the problem for weeks. The diagnosis in both cases- Goodintentionitis. Good people with good intentions failing to follow through.

Symptom 2- Broken or empty promises. More than just missing a meeting or not responding to inquiries, this aspect of the disease is particularly damaging to relationships. Managers will respond to a proposal, promising support or resources, and then do nothing. An employee (or volunteer) may expend hours of work and effort further developing an idea only to discover that the well meaning leader lacked the ability to follow through. While serving as a Medical Director at a large hospital almost every idea I presented to my supervisor was received with the words, “Great idea! We could do that!” The ideas were never supported. The supervisor was a good man who desired to achieve good things and had good intentions, which together led him to make promises that could not be kept.

What can we do about this disease? Below are some steps for those who desire to help their leaders deal with this illness.

1- Recognize the problem. Don't ignore it. Gently but firmly point out the symptoms when they appear. In private, address your leader, and say “I am not sure if you are aware, but many times people are let down because they expected a response and did not receive one.”
2- Address the symptoms immediately. When a leader proposes a deadline, ask if you can be the one to make sure follow up occurs. Contact the leader's secretary and make she he/she is aware of the need for follow up. For non confidential matters, consider cc'ng the secretary on your emails so they can assist in follow up. Most of all, do not simmer in silence. The passage of time makes it worse, and more difficult to deal with.
3- When promises are made, confirm and clarify them. Immediately. "Before I invest time in this project I want to be certain of your commitment. Can I hold you to this promise?"

4- Consider sharing this blog post with your leader. As with many illnesses, people think they suffer alone. When they realize there are many others in the same situation it may be easier to ask for help.

Finally- Stop and ask yourself if you might be suffering from this disease. If you are not sure, ask those around you, and then ask for help. I have learned that others are more than willing to hold me accountable if I ask. I often tell patients, “I will try and get back to you on this in a week. If you do not hear back from me, please remind me as I have a tendency to be forgetful at times.” On those occasions where I do need a reminder, patients are usually very gracious. They understand that Goodintentionitis only affects those with good intentions!

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Why have sex?

Parents may tell their children about sex, may even tell them to wait until marriage to do it. But very few do a good job of teaching their kids why to have sex. They need to.

While most people think about sex a lot, most people don't feel comfortable talking about it. Most people feel really uncomfortable discussing it with their children. The most awkward conversation in the world is when a parent sits their child down for the first time to have “the sex talk.” This is especially difficult for families that have worked to protect the innocence of their children. How do you discuss the act of intimacy with someone who does not yet know what the parts are, much less what the parts do?

I remember well when I had the conversation with my son. I did not want to have it but knew that the sex education instruction program at the school was approaching and felt it was up to me to make sure he heard it from me first.

As I prepared for the conversation I was struck by the fact that I needed to discuss more than basic anatomy and physiology. There is more to sexual intimacy than just the “what.” If I was going to teach my son, I needed to teach him the “why” as well. I realized in that moment how neglected this aspect of sexuality is within our culture and within the church. In spite of the neglect, I think the answer to the question, “Why have sex?” is crucial.

There are really only a few possible answers to the question, and taking them one by one provides significant insight.

Possible Answer 1- Pleasure. There is no argument that this is a primary motivation for many. But is it really the main reason? Is this why it exists? Is this a good motivation? I argue it isn't. There are many essential things in life that have pleasure as a secondary benefit. Eating and sleeping are good examples. The purpose of eating is not pleasure, it is nutrition. If people eat primarily for pleasure they will become obese and their health will be harmed. I think this is also true for sexual intimacy. It is pleasurable, but that is not its purpose. We miss its value if we believe this is all it is about.

Possible answer 2- Procreation. From the very beginning God instructed men and women to have children. Families are His idea. While sexual intimacy can lead to reproduction, I do not think this is its primary purpose. Think about it, if this was the primary purpose, then it would lose its value with age or infertility. Sex happens to be how babies are made, but it is not the main reason it was created.

Possible answer 3- The biblical answer. To create a bond of intimacy that unifies and unites one man with one woman for a life time. I have no doubt that this is the correct answer. It is declared in scripture that “a man would leave his parents and cleave to his wife and that the two would become one flesh.” Physical intimacy is intended to strengthen the bond. This is universally true and evidence for this is seen in societal responses to infidelity and in the increased intensity of emotions teens feel when they break up with someone with whom they were sexually involved. Pleasure and procreation are not negatively impacted by unfaithfulness or breakups, but intimacy and oneness are. Sex is about oneness.

It is my opinion that our culture has rejected this third answer and insisted that only the first two apply. The result is broken families, confusion about marriage and the decline of the institution in our society, along with a dramatic increase in pornography and perversion. Parents need to make sure that their children are taught differently, that they learn that sexual intimacy is a sacred gift from God that when honored and protected can form a powerful bond between a man and a woman. “Why” matters, and we owe to our children to tell them

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A Wonderful Lesson from a Boy who Drank Kerosene

Kids say the Darndest things. Some of the things they say can stick with you for a lifetime.

Several years ago a three year old boy who I had delivered was hospitalized for drinking kerosene. He had come across and an old lamp at his grandparents house a taken a swig. Since kerosene in the lungs can be a serious irritant, he was hospitalized for observation at a hospital near his grandparent's home. The following morning a doctor entered his hospital room. He introduced himself as Dr. Soandso and was taken aback at the little boy's angry response.

“You no my Docker! I want Docker Barrett!”

He knew who his doctor was, and it was NOT Dr. Soandso! He wanted me! When his mom told me the story it brought a smile to my face. I thought it was pretty cool that he was that attached to me!

Stories like this are why, when I was interviewed by my medical group for a recent ad campaign, my answer to the question-“What do you like most about being a doctor?”was, “The thought that there are people living their lives knowing that when they need a doctor, I will be there for them.”

I think there is little in life that is more important than being there when needed. Being there for our families, friends and our co-workers is a big deal. It is not always easy and it demands sacrifice, yet it is something God wants from all of us, and it is incredibly rewarding.

In whatever role we find ourselves. friend, parent, co-worker or confidant, let is all strive to set ourselves apart as the one person others will look to when a need arises.