When Your Kidneys Fail at 30, Life Changes

His kidneys were almost completely shut down, functioning at less than 5% of normal. The lab results were the worst I had ever seen. His blood count was less than half normal, his kidney disease so advanced it had suppressed his ability to manufacture blood cells. According to the lab work he was near death.

Remarkably, the lab work ordered was just routine, done to complete the evaluation of his elevated blood pressure. He walked in for his visit and did not complain of any symptoms at all. When the labs came across my desk I called him right away. He did not answer his cell phone because he was at work. He was in need of emergency dialysis, and he was at work!

He was stunned when I gave him the news and told him to go directly to the hospital. How do you process the news that at the age of 30 you need dialysis and a blood transfusion? The ensuing few days were a medical and emotional whirlwind for him as he received a blood transfusion, 3 rounds of dialysis and was told he might want to reach out to family members to see if any might be willing to be a kidney donor. It was a lot for him to process.

His story weighed heavily on my mind for the next several days. I was reminded of the fragility of life and health. We go about our days with the illusion of control and a false sense that our futures are secure. It can all come crashing down in an instant. We know that terrible things happen but we tell ourselves that the terrible things will happen to someone else. We are seldom prepared for the crisis when it comes.

As it always does, his health crisis brought a new perspective on life, faith and relationships. He gained a new appreciation for his girlfriend, who stayed at his bedside during his time in the hospital. He was forced to deal with the reality of his mortality and he was given the motivation to consider the meaning of life and what comes when life is over.

As I talked to him I was reminded of how blessed I am. I have health issues, but thus far none of them threaten my survival. I am blessed with a woman who has been by my side through thick and thin for 33 years. I have a future and an eternity that is certain and secure, guaranteed and sealed by the sacrifice of my Savior.

May his story be an encouragement to us all to take time to evaluate our lives and our relationships, of the supremacy of faith, and of our need to live beyond the moment. None of us is guaranteed additional time.

Bart

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An Offer of Prayer, Rescinded

When she offered the prayer I was both surprised and touched. When she took back the offer I was amazed.

The patient was a sweet Christian woman in her 80’s. She and her husband were in together for a medical visit and they had noticed the brace on my knee. I explained that it was due to arthritis and was worn to help relieve pain.  She instantly made the prayer offer, "Oh doctor, may we pray for you?"

“Sure” I replied. I felt a little awkward, but I thought, "why not?" 

“If we pray will you believe that God will heal you?” was her next question.

“I believe He can heal me,” I replied, “I do not think He will, but you are welcome to pray.”

“Well, if you don’t believe then there is no reason for us to pray for you,” and with that the offer was rescinded!

I was taken aback by her response. She actually believed that God’s response was totally dependent on me! I saw no point in arguing (and for once in my life didn’t) but I was saddened nonetheless. I wondered how many times in her life she had blamed herself for unanswered prayer, how many times she had thought that if she had just believed a little bit more that God would have answered.

There are many things about my faith that I do not fully understand but I am certain that God does not act according to my wishes and to the limits of my faith. I do not control Him and He is not bound by me. I pray and ask for His blessings and for Him to relieve my pain, resting in the knowledge that He is able to heal me and trusting in His ability to sustain me if healing is not His plan. He has shaped me and molded me through each challenge in life and I have learned that sometimes, pain can bring good things.

But you can still pray that God will take mine away!

-          Bart

Thanks for reading. I post 2-3 times a week on topics of faith, medicine and life in general. You can have posts delivered to your inbox by subscribing to the blog and comments and questions are always welcomed. You can also follow me on twitter @bartbarrettmd.

The Definition of Pastor

When my father-in-law was facing major heart surgery, he was there to pray. When the surgery did not go well he was there to lead the memorial service. He was not afraid or ashamed to pray with us or shed a tear with us.

When I was first asked to speak at the chapel service of our church he was there to support and encourage me. When I had questions about where my gifts fit in at the church and how I could best be of use he got up early and met me for breakfast to hear my heart and give me counsel.

It is because of him that I am regularly invited to speak to the senior adult groups at church. After my first time speaking to one of the groups he gently took me aside and gave me encouragement. His advice, to speak more slowly and to avoid pop culture references to which they could not relate, made me more effective. As I have continued to teach in that group his support has become invaluable.

He believes in me, in my heart and in my desire to serve. He respects my passion, drive and commitment, and where others have tried to rein me in he has consistently worked to help me channel it. He listens, and then he listens more, hearing my heart and not just my words.

He loves me, he loves God, and he loves Gods people. He works too long and takes on too many responsibilities. He is at an age when most men have retired but he still sees work to do and ways in which he can do it. He is comfortable in front of a crowd but is not one to seek the spotlight. He has proven again and again that he is willing to share opportunity with others. How many pastors share the Easter pulpit with a layperson?

Over my years I have been to many churches and met many men who were on a church’s payroll. Too few truly had the heart of a pastor, whose true desire was to love and serve God’s people. When I think of a pastor, I think of John Coulombe.

He is not famous or well known, nor does he desire to be. He does desire to have an impact and he has impacted me greatly.

Bart

A Backwards World. Late Patients, On-time Doctor

It seemed no one was on time. Patient after patient came in late for their scheduled appointments. I wondered how I would keep up and if I should ask the late patients to reschedule. I didn’t ask them to reschedule and I did keep up. Here is how it worked out and what I learned.

The first late patient was arrived over 20 minutes after her scheduled appointment time and had multiple issues she wanted to discuss. She had a 15 minute appointment and 30 minutes worth of problems. Knee pain, back pain, neck pain and headache. I addressed the neck pain and the knee pain and discussed treatment options and briefly discussed the headache. Out of time, I explained that we were starting a process, that I wanted to check an xray and have a physical therapist evaluate her neck, and asked if she would be willing to come back in a week or two to take the next steps. Because I was not at all behind when she arrived I was not too far behind for my next patient, who was 30 minutes late for his new patient physical.

He was so late that I called out to the front office, “Did our 10:15 patient no-show?”

My nurse answered back, “He just got here!” She was in the process of calling the patient back to the exam room. A few seconds later the patient sheepishly appeared behind her, spewing apologies for his tardiness and thanking me for taking him anyway. I wondered how I would manage to do a complete evaluation and still be on time. I didn’t have to worry, for while the patient was being roomed I answered the office phone. It was my 10:45 patient. He was stuck in traffic and running late. He wondered if I would still see him. I knew that he was commuting from 90 minutes away. “Of course I will, but it may be a bit of a wait!” was my reply.

The physical exam didn’t need a full physical exam after all and the visit did not take as long as expected. The patient was so appreciative of the service and care he received that he made up his mind to refer his brother to me for care while he was still in the exam room.

The next late arriving patient came into the office well after his scheduled appointment, but late enough to where I was able to be right on time for my 11:00 appointment. It all worked out.

He was followed by a long standing patient who I had scheduled for an hour long appointment into my lunch hour. He has been cursed with skin that likes to grow skin cancers and he needed so many biopsies that there was no good place to fit him into my normal schedule. I had the staff book the procedure during my lunch hour so I could devote the time needed. When he arrived he asked if we could do fewer biopsies than planned. He wanted to make sure I had time for lunch.

Sure enough, I finished all of my morning charting and was able to have a little over 30 minutes to grab a sandwich at the local café. As I ate my sandwich I thought of how at one time in my career I would have been stressed and angry at patients arriving late and would have demanded that they reschedule. I remembered that I was less happy and content with my practice back then and that my patients weren’t as happy either.

Later that afternoon I fell behind again when a procedure took longer than planned. I was 30 minutes behind when I entered the room of the patient that followed. I handed him a Starbucks gift card as an apology for his wait. He accepted my apology with grace, reminding me that we all need forgiveness at times and that grace and kindness make the world a better place.

-          Bart

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Why Pastors And Leaders Don't Get Fired. Even When They Should

It is always hard to address failure. When the person failing is the leader of a church it is even harder. As painful as it can be to confront a leader, the pain of ignoring a problem is almost always worse.

I read with sadness recently the reports on the demise of Mars Hill Church, a massive church in the Seattle area. The church welcomed over 12,000 attendees each Sunday to its services at 15 different venues in the city and surrounding communities and its Pastor, Mark Driscoll, was somewhat of a celebrity in evangelical circles. The church seemed to be growing and successful. Members were understandably shocked when the announcement came in the fall of 2014 that Driscoll was resigning and the church would cease to exist in its existing structure. The organization dissolved, and what was once one church with 15 locations fractured into 11 independent churches. Mark Driscoll was out of a job.

While the news caught most people off guard, it was not a surprise to those who were in the know. It seems Mark Driscoll was not a very nice man. While charismatic and gifted as a speaker, church leaders revealed that he was mean-spirited, domineering and profane in his dealings with other church leaders and members. He lacked the personal character required of those in his role. When his inevitable fall from grace came he took the church down with him. The fault was not only Driscoll's. The elders of the church tolerated the intolerable for too long and their unwillingness to act irreparably harmed the church.

Reading of the tragedy of Mars Hill leads me to reflect on why it is that churches and other organizations select, tolerate and even enable dysfunctional leadership. The fiasco of Mars Hill is not an isolated event. In my years in ministry and medical practice I have observed many men who were not qualified to lead be allowed to continue in their roles unchecked and undisciplined. The list of pastoral wrong doings of which I am personally aware includes foul language, arrests, sexual indiscretions, recurrent gossip, bullying of staff, and misuse of church funds. The list of professional malfeasance in secular organizations is even longer.  In the majority of circumstances the pastors continued in ministry and leaders continued in their roles without significant consequences. When I consider the cases of which I am aware I see a number of recurrent problems. While I specifically address the role of senior pastors, the role with which I am most familiar, the issues and principles they represent apply not only to churches but to leaders in other large organizations as well. 

Problem #1-      A Culture of Celebrity.

We live in a world that makes pastors into stars. Mark Driscoll had a salary of over $500,000 a year and commanded speaking fees of over $15,000 per appearance. Even in smaller churches the pastor can become the center of the church community, the focus of the ministry. This can lead to a fear that the church could die if the pastor leaves. As a result sin is overlooked. As long as people are coming, the pastor is not confronted. When the pastor is the focus, focus is lost. 

The Solution-  Churches need to guard against making one man the focus. This danger is increased with multi-campus churches that broadcast one pastor's preaching into multiple venues. It can be addressed by having other men assume more visible leadership roles, and by making character a priority. Talent is no substitute for character.

2-      Weak Leadership.

Elders (or governing boards) are supposed to be overseers, shepherds who guard the flock. Men in this position may at times be required to confront those who are in error. In many churches elders are poorly suited for this aspect of the job. They are often chosen or elected because they are nurturing and supportive by nature. In churches where Elders are elected there is a danger of selecting leaders who are more popular than they are firm in their convictions. 

The Solution- Churches should seek out men with proven records of character who have shown they can make difficult decisions.

3-      Change is Hard. And Risky.

No one wants to admit they are wrong, and it is not easy for leaders to admit to a congregation that they picked the wrong guy or that the right guy turned wrong. How do you explain to a church body that the man they have been listening to every Sunday is not the godly leader they thought he was? It is often easier to rationalize and ignore than deal with the fall out.

The Solution- Create a culture where self-assessment is expected. Periodic reviews of the ministry should be scheduled and results shared publicly. When self-correction is a part of the culture necessary change is less disruptive.

4-      Small Parts, Big Whole

Often times no single event is big enough to merit confronting the pastor. While multiple small events are at times indicative of a major character flaw, confrontation in such circumstances is more difficult. This can result in pastors who remain in their positions if infidelity is non-consummated, or whose bullying of staff is verbal but not physical. 

The Solution- Create a culture where leaders are expected to perform at the highest levels of personal conduct and where the truth that words and deeds reflect a man’s heart is embraced. Simple apologies should be rejected and replaced by definitive action plans and formal counseling.

5-      Misplaced Faith

We believe in a God who restores, redeems and rehabilitates. Leaders often feel that they need to give struggling pastors time to allow God to move. While this is true in most circumstances, when it comes to the senior pastor the bar can and should be higher.

The Solution- If the pastor needs significant rehabilitation he needs to step aside. There is a spiritual battle being waged and a weak general puts everyone at risk. Extending grace does not necessarily mean foregoing action.

This list could be much longer. It is my hope that pastors and leaders who read these words will be encouraged to stand up for their flocks and their faith. Scripture is filled with examples of people suffering due to the sins of their leaders. None of us want our church's story added to the list!

For those in leadership roles in other organizations the principles still apply. When we allow dysfunction to continue unchecked everyone suffers.

- Bart

Know a leader who needs to hear this message? Please consider sharing it. Comments or questions? I would love to hear them.