4 Lessons on Failure, Courtesy of a Dying Church

What happened? How did I end up in this mess? I had such great plans, how did they all fall apart? Many of us have asked these questions when confronted with failure. Failure is a part of every life, even successful ones. While dealing with failure is never easy, those times we do not succeed are usually opportunities for learning and growth. If we do not learn the lessons then simple failure becomes a tragedy.

Failure in all forms is difficult but dealing with the failure of a church is especially hard. I saw this first hand 7 years ago when I was asked to preach to a church that was in its final days. The church had at one time been a thriving congregation of over a thousand. On the Sunday I was invited to speak the congregation had dwindled to fewer than 100 and had just made the decision to hand all of their property and facilities over to another church in town. It was a sad day. It was my goal that morning to find some positive lessons in the midst of the sadness.

 I turned to a biblical story from the Old Testament book of 1 Samuel, a tale of a time when the nation of Israel faced a disastrous failure. There I found lessons on why people fail that were applicable then and are still applicable today.

In 1 Samuel 4 the story is told that the people of Israel were defeated in battle by their enemies the Philistines. The leaders of Israel came up with a solution to this defeat and prepared to reengage the enemy. They sent someone home to fetch the Ark of the Covenant (a gold plated box that symbolized the presence of God) and bring it to the battlefield. Their logic seemed to be, "God is in the Ark, so if we bring the Ark,we bring God. If we bring God, we will win!"

Their lack of true spirituality revealed when the ark was brought to the battlefield by two priests who should have been removed from office years earlier. They were incredibly dishonest and immoral men, thieves and adulteres who clearly did not honor God or His law. Nevertheless, they were deemed worthy of escorting the ark to the battlefield. Believing that the ark guaranteed God’s blessing and ensured victory, the people let out a mighty cheer when the ark arrived, a cheer so loud that it caused fear in the Philistine ranks. The Israelite joy was short lived. Their plans and thinking were revealed as foolish shortly after the battle started. They were routed by the Philistines, their priests were killed and the ark was stolen. Over 30,000 Israelite soldiers were slaughtered. 

When news of the defeat reached the Israelites back home despair resulted. The father of the priests fell over backwards at the news and broke his neck. His daughter-in-law, wife of one of the priests, was in labor, giving birth to a son when the news came. There were serious complications during the delivery and she knew she was about to die. Overcome with despair at the loss of her husband and Israel's crushing defeat she named her son Ichabod, which means, “The Glory has departed.” She died convinced that the blessings of God were gone, that the nation of Israel was crushed and abandoned. It was a dark time of great failure for the Jewish people.

A close look at the story reveals common causes of failure in communities of faith, lessons for all of us today.

1- The people tried to do it their way. They thought they could do whatever they wanted and expected God to go along with their plans. They had an idea, going to war, and tried to get God to go along with it by bringing the ark. When people and churches fail it is often because they have gone their own way and expected God to follow. Many of my greatest mistakes have come in times when I was supremely confident that I knew what I was doing.

2- The people of Israel had leaders who made bad decisions and used flawed reasoning. Following bad leaders almost always leads to failure. In the Biblical example the leaders were mistaken in their understanding of the workings of God. It was the elders of Israel who had the idea of bringing the ark to the battlefield thinking that it would guarantee victory. So often leaders are wrongly convinced that they know exactly how things will play out. They get overconfident, place too much faith in themselves and everyone fails. We see this in organizations and even Churches today which often undone by leaders who mistakenly think they know how things should work or how God moves. Incompetent leaders don't make good choices!

3- The Israelites refused to deal with bad leadership. The immorality of the priests was widely known but was allowed to continue unchallenged for many years. I have seen this in business and even in small offices. When bad leadership is not addressed, failure results. Too often organizations and faith communities will sweep dysfunction under the carpet instead of dealing with it.

4-  The true cause of their failure eluded them. They did not see that they were at fault and instead blamed God. The dying woman expressed this, saying"The Glory has departed," implying God had abandoned them. Our failures are typically our fault! Blaming others causes us to not learn valuable lessons.

My concluding points  to the sermon I preached years ago still have relevance to people and churches now.

- We need to put less confidence in our own decisions. We need to be willing to question ourselves and seek wise counsel.  For Christians, this means making sure we are following God's plans and not our own.

- We need to be careful who we follow. Organizations (including churches) cannot function if every decision is analyzed and questioned, but they can't survive if there is only blind obedience. When it comes time to choose leaders we need to be diligent and cautious.

- We need to hold our leaders accountable and not ignore their sins and repeated mistakes. Dealing with failed leadership is difficult, but it is essential.

- We need to resist the trap of thinking that failure is the end. The dying woman declared that "the Glory had departed from Israel." As we read through the Old Testament we learn that Israel's greatest days and triumphs still lay ahead of her. It is easy to get caught up in our failure and want to give up. If we do we may miss out on what God has in store. 

Powerful lessons from failures thousands of years ago!

Bart

As indicated by the subtitle of the blog, my musings range from medicine to ministry to the meaning of life. I pray those post has stimulated reflection. If you found it helpful, please share it with your friends. For those new to the blog you can subscribe to future posts by clicking the subscribe button on the page. Posts on Medicine and marriage are coming soon! You can follow me on Twitter @bartbarrettmd. Comments are welcome! For those in Southern California, you are invited to join me this Sunday morning. 10:30 at Valley Baptist Church, 2201 West Alameda in Burbank. I will be speaking on dealing with criticism and tough times.

The Foundation of a Lasting Friendship

Many friendships don't last. Some we think will last forever quickly fade while a few endure in unexpected fashion. This is a story of such a friendship.

I have known Rod for thirty-five years. When I was 18 he took me in as a roommate. 7 years his junior, he was a brother, friend, mentor and guitar teacher to me.   At times we shared evenings filled with long and deep conversations about faith and life, other times I would sit and marvel at his guitar skills, listening with envy at the beautiful melodies he created, many of which I can still play.

Out friendship has endured these years in unique fashion. We do not speak often but are always glad when we do. We have very few things in common. He loves the outdoors, hiking and nature and knows next to nothing about sports or politics. I am lost outside of civilization and am addicted to sports and am a political junkie.  Come to think of it, we have almost nothing in common!

In spite of this we are friends, true friends, not the Facebook sort, but the kind that would come to one another's side at a moment's notice without question.

We remain friends because of a single, deeply shared commonality. We are brothers in faith. In our own ways and in our own worlds we each live each day doing our best to serve the God we love, the God who first loved us and who made us brothers.

Which is why I found myself sitting alone in a coffee house in an unfamiliar neighborhood in Long Beach on a Sunday night a few weeks ago. Rod was playing, one of three artists scheduled to perform that night.

I listened to him sing about life and about loss, about a search for meaning and purpose, sharing his gifts and talents with all those God brought his way.  He was genuine and transparent, honest and forthright. He was Rod. This is who and how he is.

As I listened I was transported back 35 years, to a place where I was once again sipping coffee listening to his music and looking up to a man who possessed a level of character and integrity to which I aspired. He is still an inspiration to me.

There is no question that I would not be who I am today were it not for Rod. His friendship has been such a gift. 

- Bart

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Autism, Measles, Vaccines and Truth. Protecting the Lives of Innocent Children

He had never been embraced by his adolescent daughter, never heard her say the words “I love you,” never had a conversation with her at all. Autism had stolen all of this from him, her condition was that severe. So moving were his words that as the man testified before congress, the hearing room was uncharacteristically quiet. In addition to being the father of a daughter with autism he was a professor of infectious disease at San Diego Children’s Hospital. While dealing with the challenges of being parent of a severely disabled daughter he continued his duties at the hospital  where he witnessed firsthand the damage brought by measles, polio and other vaccine preventable diseases. I vividly remember his concluding remarks. He told the members of congress that after reviewing the data on vaccine safety and autism, after experiencing the pain of his daughter’s condition every day of her life, and after seeing all of the diseases in question, he was certain. If he had to make the decision again, he would immunize his daughter in a heartbeat.

I was stunned by his testimony. Not only by its power, but by the fact that I had even come across it. I was channel surfing while on vacation and landed on CSPAN by accident right as his testimony began. It seemed almost providential that as a physician dealing with immunizations on a daily basis I would so fortuitously come across such a valuable story.

I have repeated his story many times over the years in conversations with mothers and fathers about vaccine safety. Over the course of dozens upon dozens of such conversations I have realized that vaccine questions come from two perspectives. There are the honest questions from those who want to protect their children from diseases but are nervous and are seeking reassurance, and then there are the confrontational challenging questions from those who are convinced that vaccines are harmful. The testimony of the San Diego doctor has reassured many in the first group and had no impact at all on the second.

I have often wondered why that is. Why is it that there are some people who seem to feel that 9 years of education, 3 years of training and 20 years of practice add no value to my opinion beyond that of someone with a computer, a web browser and some time on their hands? If my knowledge and experience mean nothing, how do I reach such people?

The answer to the first question, why some people do not respect my opinion, seems to be a cultural one. From the 60’s onward children were taught to question authority and to be wary of placing trust in those in power. Since the 70’s, an emphasis has been placed on self-esteem. Everyone’s opinion matters, everyone’s opinion counts, and to an extent, everyone’s opinion is equal. The end result is that the physician/patient relationship has seen a new dynamic. Gone are the days when doctor’s recommendations were readily accepted and followed. We are having to prove our knowledge, even in common areas of practice such as vaccines.

I cannot trace its rise, but there is another factor as well, the apparent desire of people to be in an elite group, the group that is “in the know.” Knowing something that others don’t, discovering a “truth” that has been hidden, seems to be a powerful elixir. In my discussions with those adamantly opposed to vaccines this attitude has been common. There is an air of “other people may be duped, but I am better than that” that pervades the conversation. This attitude allows for dismissal of any argument I may offer.

The internet has made the situation worse, as misinformation and misapplied data abound. Evidence to support one’s preconceptions is never more than a few mouse clicks away. I have noticed in the anti-vaccine crowd it is never the reputable sites that they quote. Immunize.org, the CDC and the Mayo Clinic are passed over for activist sites that proclaim the “truth.”

What has amazed me the most in my discussions with patients (and in the responses to my blog post) is the emotion and anger associated with the anti-vaccine movement. Physicians and Public Health officials are not simply mistaken or wrong, we are often characterized as evil, deceptive, “in the pockets of Big Pharma,” or motivated by greed and avarice. The most gracious of the anti-vaccine responders express pity, displayed in condescending remarks that suggest I have been duped or am simply unaware. To imply that we physicians would either knowingly harm a child or remain willfully ignorant of information that may benefit a child under our care is an accusation I find difficult to process.

I have had so many conversations and my response to vaccine questions has evolved over the years. As there simply is not enough time in the day to engage in 30 minute discussions with every family about vaccine safety I have reduced my comments to a few simple points.

I tell my parents that life is full of risks. They risked the life of their child when they strapped her in the car seat and drove to my office that morning. A risk free life is not possible. I use the example of seat belts and airbags, reminding them that every year in America people are injured or killed because of seat belts and airbags but that we continue to use them in the knowledge that they save far more lives than they harm. This is the truth about vaccines. In rare cases some children may have a harmful response to an immunization and in exceedingly rare cases the reaction and harm may be severe. The alternative, not immunizing children, is much, much worse to society. One child may get away with it if all of the other parents immunize, but if society follows that path many innocent children will die.

The honest questioners, those with open minds and hearts and who do not believe that the healthcare industry is guided by evil forces, accept my words and have their children immunized. The oppositional deniers try to argue with me. At that point I simply tell them that I cannot provide care for those who do not think I know what I am talking about and who do not trust my judgment, who think I would harm their children. Out of concern for other patients in my practice, I suggest they find care elsewhere.

While this works for my practice society has a more difficult challenge for being unvaccinated does not only place the individual in jeopardy, it carries with it the risk that others may suffer. The recent outbreak arising from Disneyland is a powerful illustration of this risk, as children too young for the vaccine became infected by others. So what do we do?

I am not a politician or a legislator, but difficult decisions need to be made. I am of a bent that places great value on individual liberty and I am reluctant to suggest actions that infringe on parental rights yet I do think an argument can be made to stiffen immunization requirements, especially for school admission and particularly for those diseases that are most contagious. We need to be careful about drawing lines in the sand over contagious diseases which are almost impossible to transmit in a classroom setting but should be willing to make a stand with readily contagious diseases such as measles. We should not expect innocent children too ill or too young to be immunized to be made to pay the price for the decisions of others.

As a culture we need to be willing to say that not all opinions are equal and that our public health decisions will be based on science and not emotion. It is not an overstatement to say that the lives of our children are at stake.

- Bart

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Being Fired Isn't Always the End

“This is it. I am going to have to let you go.” And with that a 5 year relationship with one of my favorite employees ended. I have always hated letting people go but this one was especially difficult.

I hired her when she was 19, the sister in law of one of my other employees. I was not sure she would be up to task, being the primary receptionist for a busy family doctor with high standards is not an easy job. She excelled out of the gate, handling the phones and patients with grace and aplomb. They all loved her as her natural sweetness and willingness to help were impossible to resist. In the 5 years she worked for me I cannot remember single complaint from a patient.

I genuinely cared for her, and as she is Hispanic, often called used the term of endearment “Mija” when I talked to her. She talked to me about her life and her family and I felt as if we were as close as a boss can be with an employee.

So what happened?

Overtime she began to make mistakes. I wondered if it was due to the fact that she was trying to go to college in the evenings or if it is was financial pressure. Whatever the reason was, things started to fall through the cracks. I talked to her about it, counseled her about it and even warned her about it. She improved for a while but when one morning I discovered some patient results had not been forwarded to me for several weeks due to an oversight, I felt I had no choice but to say good-bye. I had to draw the line at quality of care. She was heart-broken and so was I.

A short time later she applied for a job with the Medical Group I contract with. They called and asked me about her and I gave them the best recommendation I could, telling them how she had been so wonderful for so long. To her credit she had been honest in the interview about all that had happened. They offered her the position.

We had limited contact over the next few years, she would occasionally answer the phone when I called the Medical Group and her sister-in-law gave me updates every once in a while. There were never any negative words exchanged and she never spoke ill of me to anyone. I never thought that our relationship would improve but was grateful that there seemed to be no hard feelings.

A few months ago the staff wanted to change cleaning services for the office. Her sister-in-law asked if she could do the weekend cleaning. “Why not?” I thought. So I hired her for that position. The job is on the weekends when the office is closed so I did not see at all and we talked only once or twice for brief moments.

In the last two weeks we have had staff shortages in the office due to vacation and family illness. Normally we would call a temp office for help or just struggle a long, but she is on winter break from college and the office staff wondered if she could fill in. “Why not?” I thought again!

And so she is back at the desk, answering phones and smiling at the patients. When she came in for her first shift we embraced, genuinely pleased to see one another. We have talked some and updated each other on events in our lives and I have been reminded of the sweetness and kindness that have always been a part of who she is. I have even called her “mija” again.

Her story reminds me of how life is supposed to work. Mistakes sometimes have unavoidable consequences. Bosses need to make changes and employees need to move on. Good people, kind people, can still care about one another and still wish each other well. We can forgive one another and sometimes even work together again. If only we could all forgive and love in this way!

-          Bart

Why Physicians Can't Care Anymore

Since the day I began training as a Family Doctor I had one goal- to make a difference in the lives of my patients. I soon realized that I had my greatest impact in the context of relationships with my patients. The better I knew the patient as a person, the more accurate my diagnosis was. Further, when they viewed me as a person, they were more likely to follow through with the treatment plan I recommended. With this in mind I have spent the last 20 years trying to build relationships with my patients. I am wondering if those days may be disappearing.

Building relationships takes time and many patients aren’t staying with their doctor long enough for a relationship to develop. This is not something they are choosing. Most patients have insurance through their employer or ObamaCare and employers, insurers and the government do not care which doctor the patient sees. They simply want affordable coverage. As a result many patients are seeing their insurance provider change every one to two years. Often they are switched to a plan that does not include their doctor. When this happens they are forced to switch to a new doctor as seeing an out of network provider would mean paying cash for visits and most patients simply will not pay the standard $80 charge for an office visit. The result is that strong relationships are increasingly rare.

These economic realities mean that January becomes a month of good-byes for doctors. Just this week I received two emails from families asking if there was any way I they could stay in my practice. One family has been with me for 17 years. I delivered their children and have been their doctor through depressions, anxieties and the loss of a parent. As much as they want to stay in my practice, the insurance won't pay, so they are moving on.

I wonder how long it will take for the new doctor to develop the closeness that will allow for effective care for emotional and family issues. Given the current environment such closeness may never develop, for within a few years the family may be forced to change again.

There is another problem facing patients and doctors as well. Insurers are cutting what they pay (up to 50% on some ObamaCare plans). In order to stay doctors are cramming more visits into their schedule, racing through the office day with nary a moment for conversation. I wonder how many diagnoses will be missed and how much poor communication will occur as the pursuit of cheap care results not only in new physicians but in shorter office visits as well. It is hard to get to know someone in 7-10 minutes!

For me personally, there is sadness. It is hard to say good-bye to people you have taken care of for years. I could contract with these lower paying plans in order to keep patients, but if I am forced to rush people in and out in order to pay the bills relationships will all of my patients will suffer. As I will not compromise the quality of care I provide and have already cut expenses as much as I can, I have no choice. I cannot contract with plans that do not pay a reasonable rate. So I watch patients leave. How tragic.

Healthcare reform has brought many changes. I do not think that the end of caring physician-patient relationships was supposed to be one of them.

- Bart