Broken Thinking, Broken Life

Adulterous affairs on business trips. Relapses into addiction after years of sobriety. Violent explosions of temper. I have seen so many seemingly good people inexplicably find themselves in situations they swore they would never be in. In each circumstance the question was the same, “What happened?” The answer was, and is, never a single thing. Tragic outcomes are typically the result of a string of bad decisions.

I think of the married patient who came to be fearful he had contracted an STD from a sexual encounter with a stranger he met in a hotel bar while on a business trip. “I made a bad decision,” was his initial explanation.

“You made a lot of bad decisions,” was my reply, “You had to run through a lot of stop signs on the road before you crashed.” I reviewed with him the bad choices. He chose to go to the bar, to make eye contact with the woman and to buy her a drink and engage in conversation. No one forced him to complement her appearance or to go to her hotel room. He could have, and should have, said “No,” so many times. Just one “No,” may have been the difference between marriage and divorce.

As we talked I thought about how his fall did not begin with wrong action but with wrong thinking. Each bad decision was preceded by a bad thought. Thoughts such as “What is wrong with buying a drink?” or “It is just harmless conversation” were the first signs of danger. I wondered if the first wrong thoughts were negative ones about his wife. Were there unchecked feelings of resentment or dissatisfaction with her appearance that led to his wandering eye? Had he quit thinking of her as a gift from God? Had she become "just another woman" in his mind?

As I look back on my life I can see that every foolish or destructive act I have made was preceded by erroneous thinking. This seems to be the fate of all mankind. We are all plagued with self-deception. The process is described in the New Testament-

“Temptation comes from our own desires, which entice us and drag us away. These desires give birth to sinful actions. And when sin is allowed to grow, it gives birth to death.” James 1:14-15 NLT

James description of the process points us to the solution. When we allow our wrong desires to take hold, when we allow them to simmer unchecked, wrong action is the natural consequence. It is hard to stop the locomotive once it reaches full speed. We need to challenge our thinking and reject the thoughts that lead us astray the moment they enter our minds, to make sure the train never leaves the station!

I know from experience that challenging negative thoughts is worth the effort. Intentionally rejecting negative thoughts about my wife has allowed a deep love and appreciation to grow and flourish, a love and appreciation that causes all other women to pale in comparison. Progress has been slower when it comes to anger, but I have seen that the more I intentionally reject demeaning or degrading thoughts about others and the more I consider them to be children of God the kinder and more patient I become. It seems that when I fight the battle at the level of thought that bad behavior is far less likely.

Which leads to the question- What is going on in your head?

-          Bart

You can listen to more on this topic on the sermons page. I expound on the topic in Part 1 of the series, “A Disease Called Sin.” If you would like me to come and speak to your church event or function, I can be reached on the Contact page. I can also be followed on twitter @bartbarrettmd, or on Facebook at Bart Barrett, MD.

Talking to Yourself Can be a Good Thing

Mornings can be difficult. Some days begin with the feeling that the problems of the day are too much, the challenges too difficult, the work to hard. It seems that you just can’t do it all again. How do find the strength to do it all one more time?

The late pastor and Bible teacher D. Martyn Lloyd-Jones gave an eloquent answer to this problem in his book “Spiritual Depression.” He wrote that we need “to not let our selves speak to us but instead we need to speak to ourselves.”

Out of personal brokenness and fallen nature come negative thoughts and emotions that can drag us down. If we listen to these thoughts, we can find ourselves struggling with depression and discouragement.

The solution? Talk back to ourselves! We need to question and challenge these negative emotions with truth. As I have been "blessed" with anxiety disorder there are many mornings when I need to do this. Here are some of the truths that I speak to my self and that help me get through each day-

- God has gotten you through every other day, He will get you through today.

- It's not about what people think, it's about what God thinks and He knows your  heart.

- You do not need to fear failure, God knows your weaknesses and loves you anyway

- God will give you the strength to do what you need to do when you need to do it.

- This life is not all there is, your hope is eternal

-God judges you based not on your failures or successes but by Christ's sacrifice, so there is no need for fear

I say words like these, take a few deep breaths and then tell myself, “Okay, let’s do this.” And somehow, with help of God, I do, one day at a time.

- Bart

Comments? Please share them! Questions? Please send them! I am on twitter @bartbarrettmd and on Facebook at Bart Barrett, MD. 

Plenty of Sex but no Purpose

He wanted to be checked for STD’s. Alcohol inspired unprotected intercourse with a complete stranger in a foreign country had resulted in an unpleasant burning sensation with urination. He was educated enough to know that this was a sign of a possible infection and that he needed to be tested. He was educated, but that had not kept him from an extremely risky act. I was curious as to what his decision making process was, wondered what the values were that guided his life and how could have been so foolish.

As we talked I learned that he was like many young men I have seen over the years. He didn’t have a well-developed system of values, hadn’t spent much time thinking about why he did what he did. He lived his life in the moment, doing whatever felt right or good at the time.

This approach to life had brought him to a place where he was not only infected with a sexually transmitted disease, he was also unemployed and unsure of what he wanted to do in life. His life resume included a college degree from a respectable university, a fair number of jobs and a large number of sexual partners but it did not include a sense of purpose or direction. He talked about jobs he thought he might like, industries he might want to work in and the lifestyle to which he aspired, focusing on pleasure and finances. What he did not talk about were the things that truly matter in life such as personal character and lasting relationships.

I asked him if he had ever considered pursuing something different, if instead of focusing on the things he wanted to do perhaps considering the type of person he wanted to be. He hadn't. I asked him if he wanted to be married someday. He said he did, so I said, “Think of the type of woman you would want to marry someday, then think of the type of man that woman would want, then try to be that kind of man!” The thought that a quality woman might not be attracted to him was clearly novel to him!

It was also clear that he had not spent any time considering his character and personal development. He hadn't even considered it. As we talked I realized that he had never been mentored or parented, had never had a relationship with a mature and moral man who had the ability to model a truly successful life. Absent such influence there really was no way that he could be any different than he was. I realized he was the unavoidable end product of modern American culture. He was motivated to consume, to experience and to have. Delayed gratification, sacrificial love and personal growth were alien concepts.

My time with him made me realize the terrible mistake parents make when we emphasize achievement and experience over character and growth. We are so obsessed with our children having successful careers that we forget to train them in successful relationships. We have forgotten to teach them that doing well means doing right. That this is no longer a value is evident by parental response to report cards. Almost no one cares about the citizenship grades anymore. It is all about the “A”.

This is not the way we raised our children and built our home. I was blessed with spiritual heritage that taught me perspective and what matters in life. Lisa and I worked hard to teach our children that what mattered most was not the job you did but the character you had. We made sure our children understood that success is not about the things you own. It is about the people you love and serve.

My son illustrates the chasm between our Christian values and the valueless choices of the young patient. Nate is about the same age as the young man who came to my office and their lives are dramatically different, a difference derived from their upbringing. My son has been married for over 2 years to the only girl he ever dated. He loves her dearly, sacrificially and completely. He is a man of faith and family who is in church every Sunday, who calls his mom several times a week and who carves out time for family on a regular basis. Out of a desire to build a life with and for his wife he has applied himself in his work and studies. He values honesty, justice and relationships. He has a clear sense of the type of man he wants to be and he is working on becoming that man. Values matter to him.

My conversation with the young patient was relatively short but is my hope and prayer that our brief interaction will help him look at life in a different way. It is not too late for him, or for any of us, to change our approach. If he realizes that who we are is more important than what we do he may find the sense of purpose and direction he has been lacking, as well as the sense of fulfillment and happiness he desires.

- Bart

He Lost His Sight, But Not His Hope

In a moment his vision was gone. It took with it his business and livelihood, his ability to read and his plans for the future but it could not take away his hope.

Fred has always been  a decent, hard-working, God-loving family man. Everything he had he worked for. He started his own painting business within a few years of graduating high school. He had his priorities in order, saving enough money to buy a home by the time he was 22 years old. He married young and he and his wife welcomed three sons before they were 35. Life was good.

He worked alone, he liked it better that way. He could have made more money if he had hired employees and expanded the business but he decided early on that it was easier and better if he did the work on his own. He loved his work and took pride in making homes look their best. My office was one of the last jobs Fred did before losing his sight. He picked the color scheme and painted it himself. It is gorgeous.

He had been born with one eye significantly weaker than the other, so much so that his vision was monocular. When his dominant eye had the equivalent of a stroke the weak eye was unable to help. In a moment his vision was reduced to colors and shapes. He cannot recognize faces well (until they are within about five feet) so the beauty of his wife’s smile is only appreciated up close.  He cannot drive and cannot paint any longer. The hardworking man is now permanently disabled.

He is disabled but he is not despairing. Fred is a man of deep faith, a man who believes that this life is not all there is, a man who believes that the eternity that awaits matters infinitely more than the temporary struggles, pains and challenges earthly life brings.

Fred’s faith has truly shined through the difficulties of the last few months. He and his family shed many tears and shared intense moments of grief as they adjusted to the new realities they face. There was sadness as he hopefully sought other medical opinions that confirmed the permanent vision loss and as he closed down his business and applied for permanent disability. 

I ran into Fred and his wife recently while out to lunch with the family. He was smiling and upbeat, more concerned with my knee arthritis than he was with his ongoing struggles. When I asked how they were doing smiles came to their faces. They were in the final stages of starting new careers working as chaplains for local hospitals and community groups! Fred expressed hope and confidence that sharing his story would encourage others who were facing difficult circumstances. It is his greatest wish that he would be able to share with others how the hope for eternity brought by his Christian faith could be their hope as well.

As we talked I was encouraged. Our discussion reminded me how important it is to focus on our ultimate destination and not on the detours and difficulties of the journey and how important it is to remind others of this hope. When all is said and done, when we stand and give account to our creator for our lives, it is not our wealth and accolades that will matter. It will be our faith and our faithfulness that will determine our destiny. By these measures Fred is doing well indeed.

- Bart

Comments are welcome. You can share the post with others by clicking the buttons below. You can have future posts delivered by email by subscribing to the blog and can follow me on twitter @bartbarrettmd

Super Bugs. A Super Big Problem.

Doctors have been warned about it for decades. If we did not stop over-prescribing antibiotics the day would come when antibiotics would not work anymore. Some of us listened, many of us didn’t and society is about to pay the price. There has been an outbreak of a nearly unkillable bacteria at UCLA Medical Center.  

The long tubes called endoscopes that are threaded down the throat and into the upper intestinal tract for certain procedures became contaminated with a particularly nasty strain of a common bacteria, one that is resistant to the most potent antibiotics. As a result of the contamination over 150 patients were exposed and a number have died. Even if this were the first outbreak of a resistant strain of bacteria there would a cause for worry.

It is not the first outbreak and there is reason to be seriously concerned. Common infections have been growing increasingly resistant to antibiotics for decades.

Staphylococcus Aureus is a common bacteria that can be found on the skin of 25-50% of healthy individuals. It is the most common cause of skin infections and can cause severe illness when it enters the blood stream. Originally sensitive to penicillin, resistant strains were discovered within just years of the antibiotic's first use in World War II. By the 1970’s penicillin was no longer effective at all.

As newer forms of antibiotics were effective against Staph there was not widespread concern. Methicillin was a readily available and relatively inexpensive alternative, and it was effective. Resistance to Methicillin was known but it was rare. Methicillin Resistant Staph Aureus (MRSA), was found in only 5-10% of hospital and nursing home infections and was almost never seen in the community. Things changed in the late 1990’s. The incidence of MRSA exploded, up to 50% of Staph infections were resistant in many hospitals. 

Within just a few years MRSA was no longer just a hospital problem. It spread into the community and healthy people began to develop severe skin infections and abscesses. I witnessed the epidemic in my practice. Prior to 2001 I treated 1-2 skin abscesses a year in the office. By 2010 I was treating 1-2 abscesses a week. The bacteria had not only become widely resistant it had become much more aggressive! Hospitals have now been forced to develop new screening and isolation procedures to prevent staff members from inadvertently spreading the disease. The world has changed forever.

The problem of resistance is not limited to rare infections. E. Coli is the bacteria responsible for the majority of urinary infections. When I was an intern in 1990, in the hospital in which I worked  ampicillin was effective against E.Coli 72% of the time and cefazolin was effective 90% of the time. Just 23 years later, UCLA (just a few miles away from where I trained), reported that ampicillin was effective only 32% of the time and cefazolin in only 68% of cases. The trend is discouraging. If something doesn’t change we may run out of effective antibiotics in our lifetimes! How does this happen?

A study I read several years ago helped answer the question. Researchers in Israel cultured all of the children in a daycare. None of them tested positive for resistant strep bacteria. One child was treated with antibiotics for strep. A few weeks later the researchers tested all of the children again. 40% of the children tested positive for resistant bacteria! Antibiotic resistance was contagious!

When a person takes an antibiotic all of the bacteria sensitive to the antibiotic die. The only bacteria left are the resistant ones. Through a variety of mechanisms one bacteria can pass its resistance on to another one, so harmless resistant bacteria can pass resistance on to harmful ones. When these resistant bacteria are passed from one person to the next the resistance spreads through the community.

In smaller “communities” such as hospitals where antibiotics are widespread the danger of passing resistance is much greater, which is why this is where outbreaks often begin. The MRSA story reminds us that hospital resistance may not stay in the hospital, and the E. Coli story reminds us that resistance is not just a hospital problem.

Since the problem of resistance and overprescribing antibiotics is well known the question arises, “Why do doctors keep writing needless antibiotic prescriptions?” The answer is simple. Patients want them and doctors are afraid to say “No.”

I deal with this issue almost every day. Patients come in with an obvious viral illness and argue when I say antibiotics are not indicated. Science, studies, statistics and the stories of antibiotic resistance do not matter to these patients. They “know their body”, “just can’t afford to be sick right now”, “want to nip this in the bud before it gets worse” or “have a friend who had this and he took antibiotics and was better in 2 days.” I often am left with a choice. Do the right thing and have them leave disappointed or angry (and maybe not come back) or do the wrong thing and have them leave happy.

The choice is difficult enough to begin with but is compounded by the reality that doctors today are judged according to patient satisfaction surveys and are reviewed on Yelp. One unhappy patient with a grudge can cost a doctor thousands of dollars in bonuses and business. Because of this the problem will never be corrected by doctors alone. Patients need to get involved.

Patients need to educate themselves and others about the dangers of antibiotic overuse. (They can start by sharing this post!) We all need to learn to allow minor illnesses to run their course and to reserve antibiotics for those rare circumstances when there is no other choice. The world is changing and we are faced with a harsh choice. Do we want to treat our sinus congestion today, or do we want to survive our pneumonia tomorrow? It appears we cannot do both.

-          Bart

Please share this with your friends. For updates about future posts follow me on twitter @bartbarrettmd or subscribe to the blog. Comments and questions are welcomed!

References-

http://www.pathnet.medsch.ucla.edu/department/cliniclab/microbio/amic.pdf     http://newswise.com/articles/day-care-centers-spread-antibiotic-resistant-bacteria http://wwwnc.cdc.gov/eid/article/7/2/70-0178_article