Needles aren't Pointless

“No way,” he said, with a touch of anger in his voice, “I am not putting that stuff in my body!”

It was clear there was nothing I could say that would weaken his adamance. In his tone and his responses this 30 year-old man made it clear that not only would he not accept my recommended treatment, but that he thought anyone who did was deluded and risking harm.

If the recommended therapy had been chemotherapy of questionable benefit, or a medication with a long list of side effects, I might have understood, but all I had asked him was if he wanted a flu shot this year. When he began to rail further against the vaccine I replied, “I have been putting that stuff in my body every year for the last 30 years!” His look said he considered me a fool.

What bothered me was not that he declined the vaccine. He is young and healthy and complications from influenza are unlikely. What bothered me was his reasoning. He firmly believes that the vaccine is unsafe.

Thinking such as his is common nowadays, fueled by social media, fringe sites on the internet, and sometimes even religious leaders. I believe this is why only 45% of Americans say they plan on getting immunized against Covid. The reasons typically given are often patently absurd, but they have persuaded millions.

Some are convinced that the vaccines are a plot by Bill Gates to implant microchips into people so they can be tracked by the government. That this is medically and logistically impossible does not seem to matter. I have heard others say they would not take any of the mRNA vaccines because they did not want their DNA changed. They believe that they will be genetically reprogrammed. In their ignorance they do not understand that mRNA cannot be used to make DNA, cellular biology does not work that way. A Catholic bishop in Fresno is urging people to forgo the vaccine because he believes it was developed using cell lines from an aborted fetus (It wasn’t, and while a very few vaccines are developed using cell lines from a fetus aborted over 50 years ago, the Catholic church has issued issued a directive advising members it is morally acceptable to receive these vaccines. It appears the bishop did not read the memo.)

I find myself asking g, “How can I combat such misinformation?” I do not know the answer, but I do know finding it is important.

We are in the midst of a pandemic that has taken the lives of over 200,000 Americans and has harmed many more. While the vast majority of people with Covid survive, this does not mean it is not a serious disease. Even young and healthy people are often adversely affected. In one study, 20% of 18-34 year-olds reported some ongoing symptoms 3 weeks after becoming infected. Covid is the public health crisis of our generation. It is deadlier than measles or flu, yet many dismiss its risks.

Miraculously, we will soon have the ability to eradicate this scourge. Less than a year since it first arrived on our shores, we have two effective vaccines on the verge of distribution. Vaccines which will be useless if people do not take them.

Bart

Hillbilly Hero

The text message from the delivery driver read , “We will shurly start when we get there we might be about done when you get there truthfully.”

Lisa and I chuckled at the spelling and the grammar, convinced that we were likely to come upon an East Tennessee hillbilly delivering our new sofa when we pulled up to the cabin. We were half right, as there were two such men lugging the couch onto the porch when we arrived.

Their appearance matched their grammar. One man, who appeared to be in his thirties, could only be described as scrawny. Dressed in jeans, a ball cap and a white t-shirt, he did not look like someone who would carry furniture for a living. He was shorter than I, perhaps about 5 feet 6 inches tall, and could not have weighed more than 120 pounds. Most striking about his appearance was what was not seen, teeth.

His younger companion, in his late teens or early twenties, seemed bigger and stronger than he was. This is not to say he was strapping. About 5 foot 10 and 170 pounds, he was big only in comparison partner.

It was fascinating watching them work together. Communicating in clear, one word responses, “Clear”, “Up”, “Cut”, as a team they easily carried the new sofa up the stairs. Watching them raise the couch over the bannister to negotiate a turn called to mind ants carrying objects several times their size. Seeing their teamwork I asked, “Who’s in charge?”

“Neither of us,” came the synchronized reply, “We’re a team.” I was impressed at the mutual humility of their response, then stunned by what came next.

“That’s my son,” said the smaller man.

His son? I quickly did math in my head. By his appearance, the dad could not have been a day over 35 years old. His son had to be at least 18 (it was a weekday during the school year), which meant that the father would have been around 17 years old at the time his son was born.

My opinions of the man instantly changed. Obviously poor and not well educated, he had achieved something that many wealthy, learned, and older men have not. He had a good relationship with his adult son.

The world (and I) could mock him for his accent and his grammar and we could look down on his station, but in one of the most important areas of life this small man stood above the crowd. He had raised a son who was willing to work hard, and if the “yes sirs” and “yes ma’ams” were any indication, a son who was also polite and respectful.

As they packed up their truck and pulled away I realized that they had left with more than a new sofa. They had left me with a few lessons as well.

Bart

GOODBYE Neighbor

Within a few days of moving into our home 27 years ago we met Ron. He ambled over from his home across the street and a few doors down, his bearded face erupting into what would soon become a familiar smile. A construction worker by trade, he had done several projects for the previous owners and he regaled us with detailed stories of the before and after.

He was hard not to like. He was a fixture in the neighborhood. It seemed he was always puttering around in his garage on some thing or another, door open for all to see, all the while keeping an eye on the homes and lives of those around him.
He watched with a purpose it seemed, for whenever we needed help, Ron would appear. If we brought home furniture, it seemed Ron would be there, ready to carry it into our home before we were. If we were having work done on the home, Ron would stroll over to see what was going on, engage the workers with a smile, and offer suggestions on how it could be done easier or better. Many times, he was right.

When our garage spring broke, he was there to prop up the door until we could get a new spring. Each 4th of July, he seemed to purposely be outside waiting to see when I would start to pump bike tires for our family’s annual ride to the parade. When I would start to struggle with the small pump that plugged into my car’s lighter socket, Ron would be there with his air compressor, calling me over so he could help.

We were not close friends, we did not have deep conversations on the meaning of life and the universe, or anything intensely personal, but that does not mean that I did not love the man. He was a rock, someone I knew would always be there to help when called upon, who would do so expecting nothing in return. I am anything but handy, but the rare occasions I was tempted to start a project I did so with the knowledge that Ron would be there if I found myself in trouble.

That began to change a few years ago. A fall at home resulted in a broken neck, and the subsequent surgery left him with a metal halo around his head. It was hard to watch him moving slowly down the street with a walker, so thin and frail. It seemed the Ron we knew was fading away. Before long he had even faded from sight. Months went by without us seeing him at all. His lowered garage door symbolized his withdrawal from the neighborhood.

A few weeks ago, we learned just how much he had lost. One Friday his wife Jeanne reached out to Lisa asking if I would be willing to stop by their house. She had been trying to check his blood pressure and could not get a reading. As I left the office I grabbed a blood pressure cuff and an extra stethoscope, stopping by to see Ron before home.

Jeanne welcomed me with a smile, but I soon saw there was not much for her to smile about. As I entered the bedroom where he lay, I was taken aback at what I saw. Big, strong, gregarious Ron had metamorphosized into a gaunt, frail, old man. To my eyes it seemed he had lost over 50 pounds since last I had seen him. His skin was pale, his cheeks were sunken and there was no spark in his eyes. I wrapped the blood pressure cuff around his arms and inflated it and anxiously watched as the numerical reading dropped lower and lower before I could hear his pulse. I checked twice to make sure I was not mistaken. The top number was 74, the lower number undetectable. His pulse was weak, irregular and over 140. He was seriously ill, perhaps dying.

Given his appearance the thought occurred to me, “Does he even want to live like this?”

I began asking questions about his quality of life, and with each response I was more convinced that the answer to my unspoken question was most likely, “No.”

His responses revealed that his mind had also deteriorated, perhaps even more than his body. Although we had been neighbors for 27 years, recalling my name was a struggle for him. I quickly went through a standardized memory questionnaire and sadly discovered that he had advanced dementia. Feeling myself emotionally shaken, I shifted my brain into “doctor mode”, did my best to suppress my feelings of sadness and loss, and began the difficult conversation about whether it was time for hospice care.

As I discussed the seriousness of his current state, the likely progression of dementia, and what that future would look like, Jeanne quickly realized that it was time. As mentally clouded as he was, Ron seemed to grasp it as well.

The next decision was mine. As I sat at the bedside looking at the man who had been so kind to my family so many times over the years, I was saddened by the feeling that I had not thanked him enough for his help, hadn’t gotten to know him better, and hadn’t been enough of a neighbor to him. I realized that now, in what were going to be Ron’s final days, I had a chance to give something back. He had been there for me; I could now be there for him. I offered to be his hospice doctor, to guide his care in his last days, to make sure that he did not suffer and that he passed with as much dignity as possible. His wife gratefully accepted my offer, and I made the call to the hospice agency.

He died 11 days later.

Although the time was short, it was long enough for Lisa and I to give back some love to Ron and Jeanne. Dementia can take a heavy toll on caregivers, and Lisa learned just how hard it had been for her. Lisa listened Jeanne’s stories of falls, messes, and unkind words, of how Jeanne had endured the types of wounds so often inflicted by those who minds are betraying them.

Lisa gave support and encouragement as Jeanne dealt with the emotions of trying to love someone who had become unlikeable at times, as Jeanne lived out the word of the vows, “for better or for worse, in sickness and in health, til death do we part.”

I stopped by frequently to see Ron, monitoring his status and encouraging Jeanne that she had made the right decision and was doing a great job caring for her husband. It was emotional for me, but I saved my tears for when I was home. I did not want to add to Jeanne’s pain. he passed away barely an hour after my last visit.

Those 11 days have had a profound impact on me and have led to countless moments of reflection. In addition to the expected feelings of wishing I had said or done more sooner, I have found myself pondering other things as well.

Perhaps the most lasting impact is my understanding of what it means to love someone. There was nothing wrong about my desire to give back to Ron because of all he had given me, but that is not what defines true love. True love is not transactional.
I am reminded of the words of Jesus, “If you love those who love you, what reward do you have?” Jesus made it clear that even bad people do that. True love is more like what Jeanne did for these last few years. Alone in her home with a man who had in many ways become unloveable, she loved him anyway. Sometimes in anger, sometimes through tears, often in frustration, she took care of him, cleaned up after him, and fed him. Love is defined by deeds, not words, and her deeds speak loudly to me.

Bart

What the Heck, God?

Life is not working out the way I planned. I had my knee replaced in February and my plan was to start going on long hikes and bike rides, to spend time with Lisa.. The plan lasted less than three weeks. My recovery was then interrupted by unexplained severe nerve pain in both legs. The pain is worse with exercise, so I am more limited than I was before the surgery,

It doesn’t make sense to me. I have seen 10 different doctors, had MRIs, epidurals, injections, and even a surgical procedure to deaden the nerves. I have had dozens of long talks with God, asking Him why I am so limited, begging him for relief, praying that I will gain a reprieve that will allow me to again live a normal life. It has been nearly 9 months now, and I do not have an answer.

How could this be His plan? Why would He have me go through so much, only to fail in the end? It doesn’t make sense.

I wonder if the Apostle James had similar feelings and thoughts at the end of his life. He was one of Jesus’ closest friends, one of the three who were always with him in crucial moments. He observed miraculous healings, saw Jesus in His glory on the Mount of Transfiguration, and was near him during Jesus’ final prayers in the Garden of Gethsemane. After Jesus ascended to heaven and the Holy Spirit had empowered the disciples on the day of Pentecost, James must have been prepared to do great works in the name of Christ.

It seems James didn’t. While the book of Acts records great deeds done by his brother John and his friend Peter, the other two-thirds of Jesus’ trio of closest friends, there are no stories of James. In the gospels the three seemed inseparable (It was always Peter, James and John) in Acts we only read of Peter and John together.

The only mention of James comes in Acts 12-

“It was about this time that King Herod arrested some who belonged to the church, intending to persecute them. He had James, the brother of John, put to death with the sword.”

That’s it. Three years with Jesus, of intense training and even miraculous deeds, seemingly all for naught. James ends up as nothing more than a footnote to the story.

How could this be God’s plan?

Why would God invest so much into someone with no visible return?

I wonder the same things for my life. I have worked so hard to be healthy, to be free of pain, to have the energy to write and teach and serve, and to be there for my family. As of now, I struggle to get through each day. How is this God’s plan?

I do not know the answer. What I do know is that I have a choice. I can choose to trust God fully and rest in the knowledge that my eternal life is secure, or I can focus on the pain of this life and give in to doubt.

It is not easy, but I choose to trust.

Bart

Too Many Apples

She was livid.

I had not cleared her daughter to play sports due to a significantly elevated heart rate and had referred her to a cardiologist for an evaluation. She understood that decision but when I went back in the chart and saw that the heart rate was also elevated at a visit a year earlier, understanding evaporated. She lost it.

“How could that happen?” she demanded. I did not have an answer. We should have caught it. It was an inexcusable mistake. Even though I subsequently made a change in the way we documented vital signs to make sure it could never happen again, the family left my practice. The mom wondered if there were other things we had missed. Trust had been lost.

I thought of this story this week as I considered the sad case of George Floyd. I found myself asking the same question. “How could this happen?” As did the mom, I wondered how many other things had been missed, how many other times police misconduct had gone unrecorded and thus unknown. I felt myself losing trust in the police.

Trust it seems, is the foundation of a society. All social contracts have trust at their core. When we go through a green light, we do so with confidence, trusting others to stop on red. We drop our children off at school, trusting that they will be not only educated but protected. When we say, “I do,” we trust the one we love to keep their promises and their vows. Without trust, everything falls apart.

I find myself wondering how many cases of abuse at the hands of police people can endure before trust is completely lost. We can say that bad apples are rare, and they are. But they are still there. Something has to be done to remove them.

Bart