Do We Really Trust in God?

What do we trust God for? When I hear people talk about trusting God it is usually when they are going through difficult times. People out of work trust that God will help them find a job, people who are ill trust God for healing, and people who are lonely trust God to bring love or friendship into their lives. While it is wonderful when suffering is relieved, God does not always help people in the way they hope he will. This begs the question, what should we trust God for?

The answer is simple to state yet difficult to comprehend. We should trust God to be God. We can be confident that God will act in a manner consistent with His character and plans and in ways that bring glory and honor to Himself. It follows that trusting God requires us to first understand His character and plans and then to make His glory our priority.

God is an infinite, eternal being who embodies perfect love, mercy and compassion, but who at the same time embodies perfect justice, righteousness and holiness. None of His attributes can be appreciated or understood apart from the others. As an eternal God He is more concerned with our eternal destiny than with our temporary happiness. He allows pain and struggle to come into our lives and then uses them to shape us into the people that He wants us to be. He allows times of need to increase our dependence on Him, and He allows us to endure the consequences of our rebellious choices so we can learn to follow Him.

This means that many of the circumstances we interpret as being indicative of God’s absence may actually be demonstrations of God working in our lives for our benefit. The worst job I ever had, with an unsupportive medical group in which I felt alone and oppressed, was a place where I was able to touch the life of a dying man and watch him come to faith. 15 years ago a virus attacked my spine, bringing with it the greatest physical pain I ever experienced.  Those few weeks of intense agony opened my eyes to the suffering of others in more than all of the previous 15 years of practice and training combined. Out of the ashes of suffering rose a heart of compassion that had not exited before.

My life testifies to the truth that suffering is a tool in the hand of God. In times of suffering I have learned to trust God more, not to meet every earthly need but to accomplish every one of His eternal plans. With each of these lessons I gain more understanding of the words of Job, “Though He slay me, I will hope in Him,” for my greatest Hope is not for blessing in this life, but the eternal life that He has promised those who truly trust in Him.

-          Bart

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Who Should Christians Vote For?

Political posts are dangerous. It seems any post that even contains the words Republican and Democrat, or worse, the names Clinton and Trump, is destined to be met with a deluge of anger and recriminations. As dangerous as political conversations can be they have seldom been more difficult to avoid. The two leading candidates for president carry so much baggage it is amazing they don’t need two planes to fly to each campaign stop. Siding with either candidate gives others the right to ask, “How can you can vote for them knowing they did all of that?”

It has been a particularly challenging election cycle for devout Christians, those who seek to allow the teachings of the Bible to inform their decisions. Many Christians have over the years based their voting primarily on social, moral and religious issues, as these issues are easy to argue and support from Biblical texts. One does not need to be a Biblical scholar to be able to find scriptural support for positions regarding abortion and marriage. This clarity made voting a comfortable and simple choice for many. This election has muddied the waters. Those looking for Biblical guidance can find reasons to reject each candidate more easily than to support them.

Christians need to be reminded that the Christian Bible has existed in its current form for almost two thousand years. It is intended to be a spiritual history of the people of God and a description of God’s eternal plan for redemption through the sacrifice of His son Jesus, not an election guide. The writers of the Bible, especially those inspired to pen the New Testament, showed remarkably little interest in the political issues of the day. These men were eternally focused and believed that a person’s eternal circumstances were far more important than their temporary ones. Eternal freedom from sin was more important than any earthly right or privilege.

This focus on the eternal continues to be relevant. I have heard many believers this election cycle talk about the importance of religious freedom. Many fear that a Christian’s ability to live and act consistent with his faith is under attack. There is no arguing the reality of this threat, but we need to remember that the danger associated with living out the Christian faith was far greater 2000 years ago in the Roman Empire that it is today. Emperor Nero covered Christians with tar and set them afire to light his garden parties yet the focus of the apostle’s teachings was on the blessings associated with following God in the face of persecution, not on eliminating the threat! In his first letter, the Apostle Peter told the persecuted church that their steadfastness under persecution was powerful evidence of the genuineness of their faith. True faith endures through difficult circumstances, therefore difficult circumstances were the test that proved faith valid to a questioning world.

In the writings of Peter and the other apostles we see other perspectives that differ from many modern American Christians. Christians in the early church did not live in a free and democratic society. Many were not Roman citizens and many others were slaves. Neither of these classes had the right to vote. Even those who were citizens and had the ability to vote had no way to influence the decisions of the emperor. The focus then was not in changing government but in accepting the sovereignty of God over government. The world was to be changed not one vote at a time, but one heart at a time. The agent for societal change was God, not the individual.

American Christians seem to have lost sight of this principle. We have grown up in a nation that emphasizes the right to vote and its importance. We have been taught since childhood that we could change the world. We are continuously bombarded with ads telling us that if we just vote for this person or this ballot measure that the “problem” whatever it is, will be solved. Government, not God, has become the agent of societal change, even in the minds of those who claim the faith. In almost every political post and article I read and in every political discussion in which I participate the emphasis is on what “we” must do, on how “we” need to change things. If only “we” could regain power and influence, if only “we” could get the right people on the Supreme Court, then all will be good again.

The evidence of the last few years has proven that the apostles were right. If we want the world to change for the better the battle needs to be won in the hearts of the people not in the voting booth. Our society is changing. Political and judicial decisions and actions are not the cause of the change, they are the reflection of it. The current debate over marriage is a perfect illustration of this truth. Christian conservatives who hold out hope that a 5th conservative Supreme Court justice will change things are deceiving themselves. A recent Pew survey revealed that an overwhelming majority of young people, 71%, favor same sex marriage, and that even 27% of adults who identify as Evangelical do as well. Same sex marriage, even if overturned by the Supreme Court of the land tomorrow, has become a value of our culture that will not be denied. Any who hope that this will be changed by an election are simply deceiving themselves.

In fact, one of the few blessings of this Presidential election is the manner in which it reveals the misplaced hope of Christian voters. It is time for us to remind ourselves that true, lasting, and meaningful societal change is dependent on our ability to influence the hearts of those with whom we come in contact, not with our ability to influence the leaders in government. The choices in this presidential election are so hopelessly flawed, dishonest and corrupt it is hard for anyone of conscience to stand with either candidate. The best arguments tend to be those made about standing against the other side. People of strong faith and conviction are faced with the choice of siding with someone who has defied a number of Christian values or not voting at all.

I have decided that my decision comes down to the value of my vote. I believe that my vote, like every action I take, is an extension of myself, an expression of my values and beliefs. If there are no candidates who reflect these values in any way, then there are no candidates to vote for. I will vote for neither of them.

This is not a usurpation of a societal obligation or an abdication of responsibility. It is an acknowledgement that the power to change society is dependent more on my character than it is on my vote. If I compromise my character I lose that power. I choose to live my life as a Christian more concerned with the eternal state of people’s souls than with the current state of American government. I will continue to vote for candidates who are worthy of my vote but I will put my hope in no man or woman.

To my Christian brothers and sisters who feel that the future of America rides on the results of this election I offer this reminder. Two thousand years ago the Church had no voice in the Roman government, yet the church endured and the Roman Empire did not. The church endured and the message it spread changed the world. God did not need politicians to accomplish His purposes then and He does not need them now. Let us focus on Him.

-          Bart

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The Night I was Arrogant and Ubered

We decided to take Uber from the O’Hare Airport to our hotel. It was far less expensive than a cab and my son’s previous experiences with Uber had been positive. As soon as we exited the airport he entered our destination in the app and clicked the icon to request a driver. The driver’s confirming phone call came within a minute. The call was quick but it was not reassuring. His badly broken English made effective communication impossible. After several repetitions of our location we were still not convinced he knew where to pick us up. We waited with trepidation at the curb, watching the app for updates and wondering if he would find us.

He arrived several minutes later and our assurance level dipped lower. The paint on the car was worn and battered. Our Uber ride was a junker. The driver  got out of the car and greeted us. At least I think he greeted us, his accent was incredibly thick and his grammar was poor.  As we opened the door and took our seats our second thoughts became third and fourth thoughts. We wondered what we had gotten ourselves into.

We had gotten ourselves into a nearly unintelligible conversation. The driver was talkative in spite of his limited fluency. We initially responded more out of courtesy than interest but as the conversation progressed and we began to adapt to his accent we found ourselves amazed at his story. While we could have predicted that he was a relatively recent immigrant to America, almost everything else he shared was remarkable and took us by surprise.

He was a refugee from Syria but he considered himself Assyrian, for that was his heritage and his culture. He may have been from a Muslim nation but he came from a Christian background. He had a strong work ethic and while in Syria he had for years been a successful business man working as a concrete contractor. He owned several trucks and his business was worth near a million dollars. He had a wife, a son, and a good life.

Everything changed with the arrival of ISIS. The destruction and havoc wrought by the war with ISIS included large scale bombings of civilian areas, included the one in which he lived with his family. An explosion had destroyed his home and killed his wife. His son survived only because he was late coming home from school and was not home at the time. His business was wiped out in a separate attack. He had nothing left except his son. He escaped to America with little more than the clothes on his back.

When he arrived in the United States opportunities for employment were scarce. His lack of formal education and limited English skills rendered him an undesirable hire. He took the best work he could find and signed up to drive for Uber. Even Uber was a challenge. He struggled to survive, as after only 60 hours of driving his account was suspended due to a system glitch and he was left without an income for several days. He persevered. By the night we met he had reached the point where he was driving an average of 10 clients a day. This was an improvement but still a challenge as he had to share a significant portion of each fare with Uber and O’Hare airport. This once proud business owner was supporting his son and himself on a little over a $100 a day. Finances were always tight, tighter the previous few months when his son was ill. Even with Obamacare,  insurance premiums took a large portion of his income.

As remarkable as his story was it was not the most amazing thing about him. What amazed me the most was the demeanor he displayed. He was kind, polite, positive and grateful. In circumstances that would have led many others to complain and despair he chose instead to press on and to work hard. He displayed a profound sense of responsibility and personal drive.

Later that evening I found myself reflecting on our ride and conversation. I thought about my initial impressions and conclusions and how wrong they had been. I thought about the characteristics that define a good man- personal responsibility, perseverance, determination, selflessness and love of family, and how richly he seemed to embody all of them. I thought also of how I had reached incorrect and negative conclusions about his character before I knew any of these things. My initial judgments were made on the thickness of his accent and the quality of his car. 

My arrogance was exactly the kind of thinking James, the brother of Jesus, seemed to have in mind when he wrote his letter to early Christians-

My brothers, as believers in our glorious Lord Jesus Christ, don't show favoritism. Suppose a man comes into your meeting wearing a gold ring and fine clothes, and a poor man in shabby clothes also comes in. If you show special attention to the man wearing fine clothes and say, "Here's a good seat for you," but say to the poor man, "You stand there" or "Sit on the floor by my feet," have you not discriminated among yourselves and become judges with evil thoughts? Listen, my dear brothers: Has not God chosen those who are poor in the eyes of the world to be rich in faith and to inherit the kingdom he promised those who love him? But you have insulted the poor...If you really keep the royal law found in Scripture, "Love your neighbor as yourself," you are doing right. But if you show favoritism, you sin and are convicted by the law as lawbreakers. James 2:1-10 NIV

I went to bed humbled at the realization that I had been so prideful and judging. I was more concerned about by comfort and what I "deserved" in a car ride than I was about the man driving the car. I was angry at myself for being a jerk yet grateful for the lesson I had learned. As I fell asleep I prayed that the lesson would be a lasting one, that I would work to become a man who sees people as God does, for the content of their hearts and not the external features of their lives.

I have a long way to go.

-Bart

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Family Medicine is Dying, can it be saved?

I hated my job. After nine years of school and three years of advanced specialty training I found myself waking each morning with a sense of dread that only increased as I drove to the office. My job as a Family Physician was nothing like what I had imagined. I had dreamed of making an impact in the lives of patients, counseling and serving others in times of illness and crisis. The clinic to which I was assigned had a different agenda. Relationships did not matter. What mattered was that patients had a doctor to see for their routine health care needs. Who the doctor was did not matter to the patients and who the patient was did not matter to the doctors. My colleagues were more concerned with their days off and going home on time than they were with the needs of the individuals under their care. The physicians in the medical group were all employees and they acted accordingly.

One of my greatest frustrations was my inability to take care of my patients when they were sick. Primary care doctors were not given room in their schedules for same day visits. Every sick patient was sent to an urgent care clinic. Appointments were booked only for routine care and follow up. These routine appointments were hard to get as most doctors were booked several weeks out.

I did not feel at home in such a world. I told others my feeling that if I was not available to patients in their time of need that I wasn’t their personal doctor, I was just a doctor. This was not what I thought being a Family Doctor was about. I took it upon myself to identify spots in my schedule where my sick patients could be squeezed in and I worked extra days to decrease my appointment backlog. My colleagues all took a day out of clinic after each night on call; I decided to forego those days off and work a full clinic day.

In some ways my efforts paid off. Within a few months I had openings in my schedule and patients could schedule a visit within two days. I was the only doctor who saw his sick patients in the office and was seeing 50% more patient visits that any other doctor. I was developing relationships with my patients. Patients loved it but my colleagues didn’t. I found myself ostracized and criticized and I began to look for a job in private practice.

It was my belief that a career in medicine was not meant to be an 8 to 5 job. Patient needs didn’t (and don’t) fit neatly into a schedule. I entered medicine to serve patients and knew that service would at times require putting the needs of others ahead of my own. I started to look for another job, hoping to find a place where my attitudes were valued. When I interviewed for positions in private medical groups I found that my beliefs were welcomed. I was told, “You belong in private practice.”

They were right. Working in private practice has been an incredible experience. The occasional long days, evening phone calls and weekend emergencies pale in comparison to the blessing of helping people in their time of need. The ability to adapt my schedule to the needs of patients, to squeeze people in or add them to the end of a day, has led to truly meaningful relationships. Because I own my practice I have had the opportunity to directly reap the rewards of my labors and also to charge nothing for patients enduring tough times. In my mind this is what being a family doctor is all about.

My mind is apparently out of date. While service may once have been the mark of the Family Physician, those days are disappearing. The new generation of Family Doctors is less interested in personal sacrifice. The goal is a consistent schedule that ends each day at 5 o’clock, a guaranteed salary and no after hours calls.

This change in physician attitudes was brought home recently in a conversation I had with the director of a Family Practice residency program. She bluntly told me that none of the doctors she is training has any interest in a job like mine. Current doctors are most interested in “work-life balance.” They want to help others, as long as they can do it between the hours of 9-5 Monday through Friday. After 5 PM, patients cease to be the responsibility of their primary care doctor and become the responsibility of the health care system, the hospital or medical group. They do not want to be bothered. The fact that patients in crisis will be under the care of complete strangers is perfectly acceptable to the vast majority of doctors and patients.

Therein lies the problem. We live in a world where service and sacrifice are no longer commonly held values. While the increasing complexity of medicine makes it difficult for Family Doctors to take good care of hospitalized patients (when your office is 20 minutes from the hospital you can't respond immediately), the only obstacle to going the extra mile in the office is personal preference. The new generation of physicians seems to prefer not being bothered. In the hierarchy of goals doing one’s best has been replaced by doing enough. For those who work for insurance companies, medical groups and hospitals, enough may be an acceptable goal. Those of us who work for our patients understand that only our best is enough.

If things are going to improve patients will need to become more engaged. One of the main reasons physicians are able to be less available and responsive is that patients accept it. Patients are people and people are creatures of habit, so many patients choose to accept poor service instead of dealing with the perceived hassle of changing physicians. If patient engagement increased, if patients used review sites such as Yelp! to praise excellence and critique poor service, if patients started to vote with their feet and moved to offices with better service, the rules of basic economics would force physicians and medical groups to improve. 

I am beginning to see this on a small scale in my office. Many patients have shown their appreciation on Yelp!, with prospective patients choosing my office as a result. (Hopefully this will continue, if you are a patient reading this, you can make this happen!).

Regardless of what patients accept, what insurance companies pay for or what others do, I am committed to doing my best to serve the patients God has entrusted to my care. To me, a changed life and a "Thank you, Doctor Barrett" are still the best reimbursement there is.

Finally, it seems appropriate to acknowledge that declining service and commitment are not limited to the medical profession. Personal service and caring are declining all around us. We can all complain about it but words are not enough, we need to do something about it. I encourage everyone to repeat the simple prayer I pray each day before as I drive to the office, "God, may I be your hands to today to touch the life of someone in need." And then look for opportunities to see the prayer answered.

- Bart

Thanks for reading and for sharing. Patients, Thanks in advance for the reviews you are about to leave on Yelp! and HealthGrades. :-)  I can be followed on twitter @bartbarrettmd, and can be contacted by clicking the contact button on the page for those who have questions or who are looking for someone to speak to their church or community group. Comments are welcomed.

When a Pastor is Never Wrong

He had been my patient for years, as had his family. He had several children, so there had been enough visits over the years for a relationship to develop. He was a pastor at a local church and we had much in common. My family had visited the church on a number of occasions and  he had invited me to fill in for him on a number of Sundays when he was out of town. It seemed a friendship was developing, so during one office visit we decided to schedule a lunch together. A few weeks later on a Friday I found myself sitting across from him at a local restaurant for casual conversation about life and ministry.

He told me how busy he was, how he felt as if he was stretched thin. It was Friday, and he had not even started to work on the sermon for the following Sunday. I had preached enough to know that it takes more than a few hours to compose a quality sermon and that he had not allowed himself enough time to prepare. I asked how his life had gotten so far out of balance. Teaching, and teaching well, should be one of a pastor’s top priorities. I asked what things were getting in the way.

He talked about his administrative and counseling duties, and then mentioned the church’s Wednesday night Bible study that he also taught.

“Why do you need to teach on Wednesday nights?” I asked

“We always have Bible Study on Wednesday,” he replied.

“I understand, but why does it have to be you to teach it? Why can’t you delegate that to someone else?” I knew the church had over 500 people in regular attendance and was certain there was at least one person or pastor who could help with the task.

“Well, people expect me to do it,” he replied, beginning to get a little defensive.

“Who cares what people expect?” I challenged him, “It’s Friday and you have not even started working on your message!” His facial expression led me to believe he was not used to being challenges in this way. His response was clearly intended to end the challenge.

“Well, I feel led by the Holy Spirit.” This was his trump card, his way of saying that he did not need to explain himself. He was the pastor, and he did not need to be questioned. Beyond that it seemed that he refused to be questioned about anything spiritual. That was the end of deep conversation that day, and the beginning of the end of our burgeoning friendship. We never had lunch again/

He was like a number of pastors I have encountered over the years. He was accustomed to being the unquestioned leader of the church, above and separate from the masses. It was as if he was closer to God than other people, more knowledgeable and more spiritual. If someone questioned anything he said or did it was tantamount to challenging His relationship with God, and that could not be tolerated.

I am certain that this attitude was protective for him. Pastors face an incredible amount of scrutiny, each day living their lives under a congregational microscope. Every joke, comment and facial expression is judged and evaluated, every misspoken word and mistake likely to be the topic of Sunday afternoon gossip or the subject of an angry email. When faced with such scrutiny it is easy to withdraw into a defensive cocoon.

As understandable as his defensive posture was, it was dangerous. He had no one in his life who would treat him for what he was, a normal person with normal failings, faults and struggles. He kept his faults hidden from others and surrounded himself with people who were unquestioning in their devotion to him. Because people who knew his weakness and who were willing to love him and encourage him to be better were absent from his life, his weaknesses were not addressed and he did not grow. The lack of accountability ultimately resulted in actions that disqualified him from ministry. A number of years later he left his job in disgrace. I have not seen him in years.

The pastor’s story is a sobering one for all of us. We often say that “nobody’s perfect”, but few of us are open about our imperfections. The truth is that it is when we are open with our weaknesses those who love us can come along side us and shore up those areas that need strengthening.

I have seen this in my own life. As a result of my anxiety disorder there are certain situations in which I do not do well. I struggle in particular with certain types of patient complaints. I can tend to be defensive and lose my temper when attacked. I have learned to reach out to office staff and ask them to reach out on my behalf when I feel I may not be the best person to respond to such a patient. They are able to act as intermediaries and gather information that allows me to come up with better and more gracious responses.

Most remarkably, I have seen that asking for help has caused my staff to have greater respect and love for me. No one is perfect, and my willingness to admit that and deal with that is viewed as a positive and not a negative characteristic. It also allows me to grow and improve at a safe and less anxious pace.

The pastor's sad story has meaning for all of us. None of us are perfect, and all of us need people in out lives who know our imperfections and who are willing to help us get through them.

-          Bart