A Tale of Two Lives

It has been a week for remembering.

In my Wednesday morning men’s group one of the young men shared stories about his grandmother who recently died from cancer. He had been raised by her, lived with her when his father was in prison while he was a child. She taught him about right and wrong, about what it means to be a person of faith. “If it isn’t in the Bible, I probably don’t know much about it,” was one his favorite grandma quotes.

She had been a source of strength and guidance for him, a constant presence of hope and faith. He told us of going through her things and finding the book in which she wrote her prayer list. The book was thick, its pages filled with handwritten names, many of whom he did not even know. Her passing meant there was now one less person praying for him every day.

Three days later I attended a memorial service for a patient, Mr. M, who had been my patient for 8 years. At his second visit I diagnosed him with a large melanoma. Within a week a surgeon removed it and for the next five years it seemed to be gone. The cancer was seldom mentioned when he came to the office. (He had a back that went out on him a few times a year, so I saw him often.)

Our conversations frequently drifted away from the medical. We talked of golf, family and work, and developed a mutual respect and friendship. We believed the cancer was in his past and that the future would be cancer free. That belief was shattered 2 years ago when a different kind of pain appeared in his ribs. An MRI scan revealed that the melanoma had invaded the vertebrae in his upper back as well as several of his ribs. It was a battle he could not win.

I sat in his service and listened as his best friend told stories of how they had met 20 years earlier and of the close friendship that followed. He spoke of the laughter, meals and motorcycle rides they shared,  and how ultimately they came to share faith in God. Mr. M’s brother-in-law shared how Mr. M had encouraged him in life and business, how he never would have achieved what he had without his input. His daughter spoke last, reading a letter she had written to her father a few weeks before he died. Through tear-filled eyes she described a man of love, dedication, strength and integrity. It was a lovely service. My eyes did not stay dry.

My patient and the grandma never met, but as I reflect on their stories I am confident that they will. The grandma lived a life of faith, daily serving God as best as she could. She died with the assurance of an eternity with Him. The patient traveled a different road. For much of His life he did not give God much thought. It was only in the last year of his life that he turned his attention to spiritual things. Nevertheless, in  the months before he passed he came to share the same faith as the grandma and the same assurance of eternity. They died within days of one another, brother and sister, adopted by the Father they were going home to meet.

Their stories move me. They remind me of both the transience and the importance of this life. My time here on earth will be brief, and may be over before I know it. Even though my days on earth will be few, the potential for me to have an impact on others is great. Like them, I want to live my life in a way that makes a difference.

- Bart

God and Blood Pressure

His blood pressure was higher than it had ever been. There had been no changes in his medications nor any changes in his overall health, so I asked him if there were any life situations that might be impacting his stress levels.

“I am under a lot of stress right now,” he said. “I am going to be retiring next month and I am really worried about it.”

He was 70 years old and his career as a salesman had been successful. As his retirement seemed both earned and due, I asked what about his exit from the workforce he was worried about. The main source of stress for him was a common one for men in his circumstances. He did not know what he was going to do with himself. He had always lived a life of purpose, but his purpose had always been work-centric. Without work he had no goals, no objectives, no goal for which he could strive.

“Are you a religious person?” I asked, “are you a part of a faith community?” I explained that many people find purpose in serving others. As a man of character and integrity it seemed that mentoring others might be something he could do.

To my surprise he seemed less interested in my mentoring suggestion than he did in my question about faith, for this was what he addressed in his response. “I have never been into organized religion,” he explained, “but I am a very spiritual person.” He shared that he had been raised Jewish but that he was “very interested in Jesus of Nazareth” and that he had been to the Holy Land several times. He spoke of being in Galilee and on the mount where Jesus’ gave the Sermon on the Mount and other meaningful moments from his travels.

I wish he had not arrived late for his appointment that day, for this was one of those “non-medical” conversational detours that I wish I could have followed further. I could not continue the conversation further, but this did not keep me from later wondering if there wasn’t a connection between his fear of retirement and his non-specific faith. When he spoke of “God” he spoke of a “being”, but not of a person, of someone who was “there” but not of someone who was near. His faith was a hope for something but did not include a belief in a specific something or someone. It seemed his faith lacked definition and as a result lacked purpose. He did not have a specific “who” or “what” kind of faith and as a result he did not have a “why” for the rest of his life.

His blood pressure revealed that lack of purpose and meaning is not without consequences. His readings had previously been normal, it was only when retirement became real that they started to rise. There is comfort in having an understanding of our place in life, and of our place in the next one, and unease and stress associated with lacking a sense of who we are and where we are going.

His concerns reminded  me of a common Christian saying, “I do not know what the future holds, but I know who holds the future.” There is peace in knowing that God has a purpose, even when his purposes are not known. Peace it seems, and for some perhaps, lower blood pressure!

-          Bart

Thanks for reading and for sharing with others. Comments and questions are always welcomed. 

Can a Christian be Anxious?

Words are dangerous things. As with a knife in the hands of a surgeon or the grasp of an assassin, whether they heal or harm depends on the manner in which they are wielded. The words of Scripture are no different in this regard. Divinely inspired and intended to further the purposes of the Loving God, when used incorrectly they can wound the soul.

In my experience, some of the most dangerous words in the Bible can be found in Paul’s letter to the church at Philippi-

“Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.”

Written to encourage believers to focus their hope on God and his eternal purposes, they are at times transformed into a cudgel of discouragement, ignorantly wielded in a manner that bruises the hearts and minds of emotionally struggling Christians. “Do not be anxious,” wrongly elevated to the status of commandment, becomes a measure of faithfulness such that the presence of anxiety is interpreted as a sign of mistrust in God, spiritual immaturity and sin.

For Christians stricken with anxiety disorder, these words can be devastating. Feelings of guilt and inadequacy, already the daily companions of anxiety sufferers, grow in power and intensity at the implication that one’s feelings of anxiousness are a sinful choice.

I have been on both the giving and receiving end of these misspoken words. In the formative years of my Christian faith I attended a church with a Pentecostal bent, a place where faith was more emotional than intellectual, a place where hurting people were “encouraged” to simply “let go and let God.” Prayers for the struggling often included asking God to help them “trust God more” or to be “set free” from sin. I joined in these prayers, ignorant of the impact of my words.

My perspective changed a little over 10 years ago. I was preparing to enter an exam room one day when I felt a sense of dread come over me. Uneasiness and fear took hold. For no reason at all I felt as if something bad was about to happen. These feelings were soon joined by pressure in my chest, lightheadedness and a sense of detachment. My mind began to race and I felt as if my emotions were about to spin out of control.

“What is happening to me?” I thought. I answered my own question as quickly as I had asked it. “I am having a panic attack!”

The intellectual awareness of what was happening gave me the strength to stall the downward spiral. I was able to calm myself partially, enough to allow myself to call my wife and ask her to bring some medication from home. I had the presence of mind to tell my staff what was going on, and to ask them to reschedule some of my patients. It took a while, but with great effort and the calming presence of my wife I was able to finish my work day.

In the weeks that followed additional attacks came. I found myself in fear of the next attack and what it would do to me. I developed other fears as well, including intense self-doubt in personal and professional interactions. With the fears came increased irritability as I struggled to regain a sense of control over my life and thoughts. I saw a doctor, and with the help of counseling and medications learned to deal with a new reality.

I have not been the same since. While debilitating moments of panic have been rare, fear and anxious feelings now greet me every morning. Their voices are quieter some days than others, at times easily drowned out by the clamor of the day, but they are always present. Countless hours in prayer and Bible study have made one thing certain. Telling myself, or being told by others, “Don’t be anxious”, does not help.

It does not help, because the words of Paul (and Jesus in the Sermon on the Mount), were not meant to be used in this fashion. New Testament teaching about anxiety is never directed at the generalized sense of unease associated with a serotonin imbalance, it is directed at the human tendency to obsess and focus on earthly needs in a way that is contrary to a life of faith.

When Paul wrote to the church at Philippi, he was in prison, awaiting a possible death sentence. The church was being persecuted and many believers were suffering for their faith. It would have been easy for them to out of fear turn away from God. To these people, in these circumstances, Paul said, “Do not be anxious… but make your requests known to God.” Similarly, in the sermon on the mount Jesus reminded people not to focus on material needs, but to instead trust in God’s eternal purposes.

Paul was not saying that all anxiety was sin, or that Christians should never be anxious. He was acknowledging the danger that in focusing on the sufferings of this present life Christians can become discouraged. He therefore reminded them of the alternative, to focus on God and his promises.

I do not believe feelings of anxiety are a measure of anyone’s faith. Faith is displayed not in the absence of doubt or fear, but in the choice to trust God and his purposes in their presence. I do not say to myself, “Stop being anxious and trust God.” I instead say, “Yes, you are anxious, trust God anyway.”

These words do not take my anxious feelings away, but they do put the feelings in context. I am reminded that I will not be anxious forever. Eternity awaits, free from both emotional and physical pain. In that hope I find hope, peace, confidence and strength. I also find, strangely, a sustaining sense of joy.

Bart

While the focus of this post has been on Christian perceptions of anxiety it is worth noting that bad counsel is not limited to people of faith. Patients often tell me about family and friends not understanding their struggles, of being told that there is no reason for them to be anxious. I typically smile as I point out that this is why it is called an anxiety disorder. Normal people worry for a reason, people with anxiety disorder are often anxious for no reason at all. 

All patients with anxiety, regardless of faith, should be encouraged to get help. Counseling, in particular Cognitive Behavioral Therapy, is extremely beneficial. Medications, especially selective serotonin reuptake inhibitors, can also be tremendously helpful tools.

The Most Important Part of Church

A patient came in recently who I had not seen in a few years. I have known him for quite a while as we met 10 years ago at a church we attended in Irvine. We weren’t particularly close back then but he apparently thought enough of me to select me as his physician. 

As we had met a church it seemed appropriate to ask how things were going at the church he attended. He shared that they had switched churches recently and that he was now going to a different church in town. Ironically, it was a church my family had attended 15 years ago.  When I asked him why they had changed to this church his answer was a common one, that his kids were comfortable in the church's youth group.

After the visit I found myself pondering how it is that people choose a church. The common answers I have heard over the years include style of music, size of the youth group, and "relevant" or entertaining teaching from the pulpit. An answer that I have never heard is the one that should be the most important- church doctrine, the specific beliefs taught from the pulpit.

In the last few years I have seen firsthand the impact bad teaching can have on a congregation. Not too long ago I  heard a pastor in town demean the struggles some Christians have with their faith. "If reading the bible is a chore, if prayer is a struggle for you, you do not know God," he proclaimed. His casually false teaching made it difficult for people to speak truthfully about their struggles. Patients who attend the church have told me stories of having their faith questioned if the shared of any personal challenges. Guilt and shame have at times taken the place of grace.

A well known North Orange county pastor recently came to the conclusion that the Bible wasn't fully accurate. He shared with his church and his online followers that the Bible was written for specific people at a specific time and place in history, and that much of it no longer applied. I know some of his young followers took his words to heart. They "discovered" that the parts of the Bible that spoke of sexual purity no longer applied to their lives.

Both of the churches led by these pastors have been "successful." They are well attended and the pastors are loved and praised by their church members. In spite of their apparent success I fear for them. To be successful in God's eyes requires pastors two accurately proclaim God's word. Doctrine matters. Correct theology is important.

I know this is important because it was important to the Apostle Paul. When he penned letters to the pastors he trained, when he instructed them on the things to which they needed to be faithful, sound doctrine was high on the list. Several times in his letters he mentioned the importance of correct teaching. He was clearly aware that a faith filled with new believers would be susceptible to error. There was a significant danger that the tenets of the faith could be altered or lost. In this environment faithfulness to the truth was essential.

The importance of sound doctrine remains to this day. A faith without consistent beliefs is not a faith worth believing in.

Unfortunately Paul’s admonitions about sound doctrine have lost emphasis in many churches. The focus is on acts of service and self improvement instead of on right thinking about God. As important as good deeds are, the reality is that if our theology is not correct we are nothing more than a social club. Why we do what we do matters. What we believe matters. We cannot be people of faith if we do not even know what we believe in.

-Bart

Ulcers, Easter, and Truth

Truth is at times unbelievable.

By the early 1980’s medical experts were certain they understood the causes of gastric ulcers. As the stomach is an acid secreting organ, and because acid can damage tissues, everyone knew that acid was the reason people got ulcers. Because ulcers were more often found in urban businessmen, doctors concluded that stress had a role. This theory was “confirmed” by studies in rats that showed ulcers developed when rats were wrapped in straight jackets and dropped in ice water, and when research showed antacids prevented these ulcers.

Enter Barry Marshall, an internal medicine doctor in Perth, Australia. Along with a pathologist colleague, Robin Warren, he gathered evidence that ulcers were the result of a bacterial infection. Further, he found evidence that the bacteria was a root cause of stomach cancer. He started treating ulcer patients with antibiotics, with remarkable results.

The medical community refused to accept his findings. They thought they knew the cause of ulcers, and could not believe that a bacterial infection could be the cause. It did not make sense. Bacterial infections were the cause of acute infections, of pneumonias and ear infections and sinusitis and cellulitis. They did not cause chronic infections, and they definitely did not cause cancer. Marshall’s theory was simply unbelievable.

It was unbelievable, but it was true. Convinced of the truth of their claims, Marshall and his colleague fought for their findings. The medical community took longer than they should have to accept their research, but the eventually did. In 2005 Marshall and Warren, were awarded the Nobel Prize for medicine. They changed the world of medicine forever.

Their story came to mind today as I thought about Good Friday and the Easter Story. The Gospel accounts tell an unbelievable tale. The Bible declares that Jesus of Nazareth, a Jewish teacher of dubious parentage, was actually the Son of God. This Son of God, instead of asserting his right to rule and demanding that all honor and worship him, allowed himself to be put to death at the hands of the Romans who governed the conquered Jewish nation. He was publicly executed in brutal fashion, nailed to a wooden cross where he hung until in agony he died.

The story did not end with Jesus’ death,  the New Testament writers report that 2 days later he appeared alive to many of his followers. He had risen from the dead, in so doing proving to the world that he was indeed who he had claimed to be, the Son of God and the savior of the world.

What an unbelievable story.

So much of the story does not make sense. Why would God decide to live as a man? Why would he choose to die? Why couldn’t he just choose to forgive everybody without going through such suffering? How could someone come back to life after two days in a tomb. There are too many “whys” and “hows”.

The story flies in the face of so much that people know. The story is unbelievable.

That does not mean it isn't true.

- Bart