Life isn’t Boring

What makes living worthwhile? What gives value to a life?

This week came the story of a man with a pistol taking the lives of 11 people in a bar. In an Instagram post written during the killing spree the murderer gave his reason for taking the lives of others. “Life is boring, so why not?”

A few days later my wife and I participated in the “Walk to end ALS.” (ALS is an always fatal progressive neurologic disease, also known as “Lou Gehrig’s Disease) We walked in support of a friend from church who has battled the disease for the last four years. Over 30 of our church friends walked together, each with their words, steps and donations saying to our friend, “Your life matters, you matter.”

It is a confusing world. One young man in perfect health decides that his life, and the lives of strangers, are worthless. In a matter of minutes he sacrifices multiple lives on the altar of his boredom. To him, human life was insignificant and disposable.

At the same time another man, cursed with an incurable disease, fights for every precious moment. His love of life and love of others is contagious and encouraging. To him, life is a gift from God, full of meaning and meant to be treasured. 

There can be no denying that it is my friend who has the right perspective. Life is not boring. It is precious. 

Bart

Small Town Jesus

I have read the gospel accounts dozens of times. Many of the stories are familiar, so much so that I sometimes catch myself skimming them instead of reading, nodding to myself and thinking, “Oh yeah, this is THAT story!”

Matthew 9 begins with such a story, the account of Jesus returning to his home town of Nazareth. Matthew recounts how he was greeted by Nazarenes carrying a paralyzed man on a mat, bringing the man to Jesus in the belief that Jesus could heal him. Moved by their faith, Jesus did heal the man, but not before first telling the man that his sins were forgiven. This claim by Jesus of the authority to forgive sins was profound, an implicit claim to an authority that resides only with God. The subsequent act of healing was intended as confirmation of that authority.

There is a lot to unpack in the tale, about Jesus’ nature, mission and authority, but it was not until this last week that I became aware of another aspect of the story that had previously evaded me. In preparation for discussing this passage in my weekly men’s Bible study, a question came to mind about Jesus’ return home, “How many people lived in Nazareth?”

The answer is not in the Bible, so I did what any modern-day Bible scholar would do, I googled it. Lo and behold I found an answer. Scholars think the town was very small, so small as to be insignificant to people of the day. According to one article I found, the population might have totaled only 400 people.

This fact dramatically changed my understanding of the passage. In towns of 400 people, everybody in town knows everybody else in town. They know your family, your parents, your skills and abilities. They knew who you were as a child, and watched you grow up. There are no strangers in a small town.

Which means that there is a very good chance that the people who brought the paralyzed man to Jesus knew Jesus. They remembered him as a child, as a carpenter, and probably as a friend. They knew the Jesus who for 30 years had done no miracles, and who had perhaps not even taught in the synagogue. They knew Jesus before he was Jesus the Messiah.

Which means that their faith was different. The other towns Jesus visited were encountering him for the first time. Their first experience with the Messiah was of witnessing a profound spiritual lesson or miraculous healing. For them to believe in Jesus as the Messiah they had nothing to forget, no previous experiences to overcome. For the people in Nazareth the challenge was greater. The Jesus they knew, the man displaying such power, had not manifested that power in their presence before. This man, who could heal the sick and make lame men walk had for some unknown reason not healed anyone, including the paralyzed man, during the time Jesus lived in their town. This knowledge and experience with Jesus meant that for them to believe their faith had to be greater than the faith of those in other towns. I wonder if this is the reason Jesus was so moved by the faith they displayed.

Not only did they remember Jesus, Jesus remembered them. They may have been childhood friends. There is a good chance that he had firsthand knowledge of why the man was paralyzed, including any potential family guilt, remorse or sadness at his plight. When Jesus said, “Your sins are forgiven,” it may not have been a generic, non-specific act of forgiveness. Jesus likely knew specific things that the man had done, perhaps even some things the man considered unforgivable.

Jesus also understood the obstacles they faced in having faith. He knew that they needed to be able to see him as Jesus, the Messiah and Son of God. With this in mind, he prefaced his act of healing with a statement of forgiveness, a statement of Godlike authority that was blasphemous (unless it was true!) In so doing he made it possible for them to understand who Jesus truly was.

Wow! The passage wasn’t as familiar as I thought it was!

-          Bart

I have not made a habit of religious blog posts over the last few years, as I know there are many who subscribe to the blog who may not be interested. Nevertheless, I have been leading a men’s bible study each week and the insights shared by the men in the group have been too remarkable to not share. For the near future I plan on increasing my posts to twice a week. My typical weekend posts will continue, but I am adding a midweek post that will focus on something gleaned from the men’s group. Feel free to read, share or ignore at your leisure!

Sometimes it is Better to Lose

Our culture has lost its way and its priorities, a fact that is on display every November. Our mailboxes, inboxes and TV screens are inundated with political ads filled with lies, half-truths and personal attacks. Truth and facts are inconvenient irrelevancies readily sacrificed to the god of political expediency. Winning is all that matters it seems, but the truth is that there are things more important than winning.

I have a good friend running for re-election to the school board in Los Alamitos. I have known Jeff for over 30 years (we were medical school classmates). We have worked closely together in leadership roles for the hospital staff, including on the physician well-being committee which deals with doctors struggling with substance abuse and other serious issues. Jeff handles the cases with grace, dignity and class. He is the volunteer medical director for a charity that serves women recovering from abuse and neglect, and in his free time is a reserve officer with the Orange County Sheriffs Department. On top of all of these activities he has served his community as a member of the school board. (Where does he find the time?!) Jeff is a truly good and honorable man.

Which apparently does not matter to someone who is against him serving on the school board. This someone recently stated putting signs around the city that read “Dr. Jeffrey Barke, Bad for Women, Bad for Students.”

While I know Jeff well enough to find the sign’s claims laughable, the truth is that the overwhelming majority of people in the city don’t. I am more politically informed than the average voter, but when it comes to my local school board all I know is what is listed on the ballot. I don’t think I am alone in this regard as most of those running for these “lesser” offices do not have the financial resources required to fully inform voters. As a result there is no way for them to defend themselves against personal attacks.

I thought of this recently when I received emails and ads attacking some of the candidates for city council in Huntington Beach. The ads were funded by special interest groups. I have to admit the ads influenced my vote. I read the ads against the candidates and decided that if these special interests so desperately wanted to keep these men out of office, they deserved my vote!

I think this might be my new voting strategy for local non-partisan offices. If winning is more important to you than kindness, dignity and respect, you won’t get my vote. If it is so important to you that you are willing to lie and cheat in your pursuit of victory, you aren’t the type of person I want.

Perhaps the first step in restoring truth and civility to our political system should be refusing to vote for those who aren’t civil and truthful!

Bart

How to Find Nice People

Deep Creek Trail, Great Smoky Mountains National Park

There is so much rudeness and meanness in the world that I sometimes wonder, “Where have all of the nice people gone?” I do not know where all of them have gone, but based on 6 days of first hand observation I have reached the conclusion that a great many of them are in Tennessee. I have experienced so much kindness, goodness and politeness this week on vacation that I may go into withdrawals when I get home to California.

We have been in the Smoky Mountains this week (which, unbeknownst to most of my California friends, is a huge national park and tourist area) watching the leaves turn orange, red and yellow, listening to Southern Gospel Music at Dollywood, and eating unhealthy amounts of fried food. Wherever we found ourselves, it seemed every waiter or waitress, cashier or attendant took an interest in where we were from and in making us feel welcome. The people reminded me of the dog from the movie “Up”, it was if they all felt that they had just met me and they loved me.

Today we went for dinner at a place called “Elvira’s” a café about a mile from the cabin where we have been staying. We received the typical warm and friendly greeting but this time with a twist. It was given in a distinct Russian accent! The owner of the place, a woman in her 30’s, had emigrated from Siberia a little over 15 years ago. In typical Tennessee fashion, she took the time to share her story with us as we finished our dinner.

She was a linguistics major in Russia specializing in British English. She traveled to America to work on her language skills (She said that at the time her conversational English primarily consisted of, “Pardon me, but can you repeat that?”) She knew very little about our country and her knowledge of US geography was limited to New York, Los Angeles and Texas. She did know that she wanted to see American rollercoasters and therefore eventually ended up in Pigeon Forge, Tennessee at Dollywood. She fell in love with the Smoky Mountains and never wanted to leave.

She moved here, became fluent in the language (She can pull off a perfect southern accent), and eventually became a citizen. Seven years ago she opened her own restaurant. She told us her family marveled that all she had to pay for the government permit was the $20 business license fee at city hall. Her Uncle Sasha couldn’t believe it and kept asking her who else she had to pay off! She spoke with joy at her good fortune in being able to live in America and be an American. Freedom is a gift she clearly appreciates and values.

This appreciation of America was something we saw displayed several times this week. One of the gospel groups we heard sang a version of “I’m Proud to be an American” during their show. The entire audience rose to their feet and sang along. We went to a family dinner show another evening that closed with a medley of “America the Beautiful” and “God Bless America”.  The entire audience, similarly unprompted, also stood and joined in, and applauded loudly. They love their country.

Things in Tennessee were much simpler, slower, and more genuine than they are in California. The area is nowhere near as affluent as Orange County, but the folks here seemed happy, content and grateful. It was a good week. Hopefully I will be able to bring some of the nice home with me.

Surprised by Cancer

The patient’s symptoms defied explanation. He wasn’t sleeping, felt as if breathing was a chore, and had persistent pain in his abdomen that wrapped around into his back. He had been suffering for weeks and was at the end of both his physical and emotional ropes. Multiple physicians had already been consulted, dozens of lab tests had been ordered, and a stomach specialist had even put a camera down his throat to check out his stomach and esophagus. No answer could be found.

I was not hopeful. His symptoms were unusual individually, together they were beyond confusing. As intense as the symptoms were, they did not fit any diagnosis with which I was familiar. After hearing his story and performing a brief exam I sat quietly and thought, completely dumbfounded. Other doctors, similarly perplexed, had told him that he was having anxiety. While this was a possible explanation (and an easy one at that), it didn’t make sense to me. I had seen hundreds of anxious patients over the years, many with physical symptoms, but none whose complaints matched his.

I went over his labs again, looking to see if anything had been missed. His potassium had been off, and I remembered that abnormalities of cortisol production were often associated with changes in potassium levels. It was a diagnosis I had seen only once, and that was over 20 years ago, but I went ahead and ordered the test.

That night I sat at my computer and searched for other possible causes. I read about rare conditions I had never seen before and vaguely remembered from medical school. Nothing fit. I decided that if the cortisol was normal I would blindly look everywhere I could. I knew I would probably not find an answer, but I was determined to be thorough in my search.

The cortisol test was normal, so I decided to order imaging tests. Deciding which tests to order was also a challenge. His symptoms were nonspecific so I was not sure where to start, what body part to image first. Frustrated and uncertain, I decided to order CT scan images from his neck to his waist. I doubted I would find anything but I could at least tell the patient I had tried.

He went in for the scans the next day. The phone call from the radiologist came the day after. “I am not sure why you decided to include the abdomen in your order, but it is good you did,” he said, “he has a 5 centimeter mass on his right kidney.”

I felt the color drain for my face. “Oh crap,” the words came out of my mouth involuntarily. 5 centimeter kidney masses are always cancer. I did not know whether it was dumb luck or divine intervention, but I realized that my decision to take pictures of everything may have just saved his life. Importantly, the scans showed no signs of spread, suggesting we may have caught the cancer in time. I could not explain how or if the cancer was related to his symptoms, but I had found it!

I spent the next few days reflecting on the near miss, on how easy it would have been to not order the tests, to refer him elsewhere or blame anxiety. I realized that I had found the cancer not because I knew what I was looking for or because I understood his presenting symptoms. I found the cancer because a patient was worried that something was wrong and I believed him. 

My reflections included memories of times when I did not believe worried patients as I should have, of concerns I may have dismissed and diagnoses I may have missed. I promised myself to be better in the future. I cannot always know, but I can always listen and I can always care. 

- Bart