Graduation, When we Shoot Arrows at The Enemy

http://www.greenvilleonline.com/story/opinion/2017/05/25/its-time-launch-our-arrows/343820001/

We have a quiver full of arrows in the house. Over and over again, the kids and I have used the target arrows it holds. Many of the arrows are worn and dinged, and some fletchings have come loose. (I have no idea how many rest beneath the grass or are stuck into trees in the woods.) The remaining arrows are sentimental to me, but still see use now and then as the mood strikes us.
Since yet another of my children prepares to graduate high school, I found myself thinking of Psalm 123: that says ‘like arrows in the had of a warrior are children of one’s youth. Blessed is the man who fills his quiver with them.’ Jan and I are about to launch another ‘arrow.’ But not at a target. Our son Elijah is being launched into the great battle of life. And as I heard a preacher once say regarding that passage, ‘what do you do with an arrow? You shoot it at your enemy.’
I am unapologetic about the martial metaphor. We live in a time of conflict, contention and danger. And no matter what one’s political, cultural or spiritual alignments, the fact remains that our children go forth into difficult times.
There are physical dangers, of course. The cowardly murders in Manchester, England remind us that violence lurks in the world and no amount of lovely colored buildings or candlelit, hug-filled marches will impede those who find its use expedient.
Cruelty is timeless and knows no borders. Slavery is still widespread, in the world at large and even in the US in the form of sexual and financial exploitation. Women of every race and creed are treated horribly in many lands. Globally, children die of starvation, dehydration and assorted diseases that we can easily manage in even the lowliest American hospital.
War continues to raise its endless Hydra-head. Gang violence robs necessary, beloved young people of their potential and their lives. Domestic violence and child abuse are rampant; especially in SC, sadly enough. Addiction is an entire war in itself, demanding aggressive action to save lives and families.
There are also political dangers. On both sides of the political aisle, there is fear that the glorious traditions and safeguards of the Republic may be imperiled. Each thinks the other is wrong. But each is concerned about something; each side has a sense of unease.
There are many battles to fight. Some compassionately advocate for equality of groups marginalized by race, gender or sexual orientation. Others battle for preservation of freedom of conscience, for the precious right to believe and act based on faith and tradition rather than cultural trend.

There are battles for abortion and against abortion, for open borders and for more regulated immigration. Climate change pits economic interests against environmental, both making important arguments for the future. Behind each lies the war of objective truth versus the cheap manipulation of spin and emotion.
Hardly a pep-talk for graduation, is it? But that’s the lay of the land. Graduation is beautiful and thrilling and all of us try to stifle our tears and cracking voices as we applaud our young people and give them hope.
But I want to give all of them, my own incredible son included, more than pretty images and vapid platitudes about ‘following your dreams.’ I want to say this: ‘It’s tough out here; we’re ready for reinforcements so get with it. Welcome to the team. Keep your heads down.’
I find that a more useful and thrilling thing than what graduates are all too often told. I want to see them launched at the problems of the world, in the full knowledge that it isn’t safe, that it isn’t easy, that they have a purpose in all the struggles and that they are needed. We need their courage, their insight, their creativity. We need their brilliance, their success, their strong backs, their loving hearts.
We live in a culture of increasing self-interest. Young and old spend too much time reflecting on their own wounds, victimization and identity politics. These things pull us apart rather than uniting us in the fray.
Dear graduates, look up and look around! Show us how to rise above ourselves and live well, how to glory in the struggle, how to win (or lose) with compassion and love, and also with ferocity and risk when necessary.
We loose you, dear arrows at the various enemies we face.
Strike true.
And congratulations, Elijah and all.

 

A Wedding is the Portal to the Mystery of Marriage

Congratulations Meg and Tyler!

This past weekend we celebrated the wedding of our dear friends Tyler Jordan and Meg McCall.  It was an event filled with the the grace of  God, expressed in a truly perfect Spring evening, in the love of parents, friends and the blessed couple.  It was conducted in all the glorious, meticulous yet casual elegance of the South Carolina coast.  All of our children were in the wedding party (along with many other wonderful folks). I was privileged to be able to deliver this short reflection at the wedding.  Thanks to Meg and Tyler for including me!

A wedding is a beautiful thing. It is a celebration, and in life’s troubles we celebrate too little. At a wedding we smile, and cry. We laugh and dance, we eat and drink and send a new couple on their way into life. A wedding is an event where others witness and affirm our vows, in order that others may help hold us to our promises. Wedding ceremonies are much valued in our time, and we spend great amounts of time and treasure to make weddings beautiful and memorable, to make wedding dreams come true.

However, despite its beauty and wonder, the wedding is not an end in itself. It is a gateway which serves to fuse two into one. When a man and woman walk through that gateway, through that portal, they enter into a beautiful mystery.

Beyond the vows, the veil, the ring and the kiss lies previously unseen, unknown garden of their common life together. That life is a new creation waiting to be unveiled and explored, shaped and molded hour by hour, day by day, year by year over a lifetime. In so doing they are living in the spirit and tradition of Adam and Eve all over again.

St. Paul says that this is a great mystery. In Ephesians 5:31-32 he says, after a profound explanation of the relationship of husband and wife, ‘For this reason a man shall leave his father and mother and hold fast to his wife, and the two shall become one flesh. This is a profound mystery, but I am talking about Christ and the church.’ We’ll circle back to that last bit in a moment.

Here Paul uses the Greek word Musterion, which means ‘a mystery that can be revealed or discovered through God’s revelation.’

The mystery of marriage is not ineffable, because God who created it is constantly teaching us through it. It is not beyond comprehension. It does, however, require that we be committed in order that we understand its riches and metaphor. It cannot be approached tentatively, with one foot in to test the water, but all in, with all our hearts.

To comprehend the mystery of marriage we can only cross the portal, and in faith and hope and love leap headfirst into the unknown. And it is an unknown.

Dating and courting and all the time we spend together before the vows are exchanged are critical. They help us to learn who it is that we can indeed spend a lifetime loving. But something different and mystical happens when we take the plunge of matrimony. Suddenly, the world takes on a different light in the power and energy of the fusion of two into one.

Through the mystery of marriage, through the great unknown garden of life together, we learn small things. That our beloved is beautiful to us first thing in the morning and last thing at night. That our beloved is a human with frailties, failings and annoying habits, but that they are no worse than our own. We wonder, at times, why they stay with us; at others why we stay with them. And then we all laugh at the fact that we both ask the same questions.

We learn that the one we committed ourselves to is cherished and precious like nothing we ever grasped or imagined.

We learn to be humble and thankful in times of joy and gracious and hopeful in times of suffering. We learn the mystery that those words, so often spoken about richer or poor, sickness and health, take on very real meaning in the hot forging fires of life.

We learn that whatever else may fall apart, whatever else may evaporate before our eyes, whatever trials life visits upon us, if we are together we can endure.

Marriage is the first place where we perhaps truly understand what it means to love someone so much we would rather see ourselves suffer or die than have it happen to our partner.

It is hard to impress upon the young, but in a marriage properly tended, in our own small Garden of Eden, love only grows deeper and wider with every passing year, every financial struggle, every wrinkle, every illness, every success and every day, or night, spent together.

Ultimately we find that looks and wealth come and go, but as we are made more and more into one, the greatest gift is their hand in ours, their warm body sleeping next to our own. This is an ageless, timeless blessing.

This is part of the mystery. The discovery that love is not contingent. That it is not contingent on youth or beauty, success or power. That it simply grows; possibly deepest in trouble, despite how we all hate to pass through it.

Over the years and decades, we become mysteriously intertwined. We are made one by our vows, but we are transformed into one by time, by shared stories, by shared goals and struggles, by neurochemistry… for all we know by genetics as each physiology impacts the other.

If you doubt me, ask those people you know who have loved long and well. It is hard to put into words, but in marriage, in time, the things we thought valuable and desirable fade away, and we desire our beloved above nearly all.

So much so that we cannot fathom, especially in youth, the phrase ‘tell death do we part.’

But that’s where the mystery delves deeper and more wonderful. What we are learning in the mystery of marriage, as wonder after wonder reveal themselves, is that our marriage is a microcosm of the love of Christ for the church.

It teaches us to love unconditionally as he does. It teaches us to love without fail, with no term limits or expiration date. It teaches us to love when we are wounded and when we are hopeful. It teaches us to forgive and love more and more. And it teaches us that all of this is an end, THE end, in itself. We do not love for meals or laundry, for support or company. We love because in love we reach God.

And there is one more thing. This love of Christ for the church will carry us beyond. The painful mystery of separation in this life is not in our power to overcome. But it is in his power. And that is the promise.

Our love for our spouse will be interrupted one day. But it will go on for all eternity in the Kingdom of God as every tear is dried and every sorrow comforted. And in that place we will see the kind of love for all that we in our mortality took a lifetime to learn for only one.

A mystery indeed.

And today, we are witnesses as the story of wonder and mystery begins once again in these two young lives about to become one..

So let there be joy and laughter in all our hearts as we witness things far beyond our comprehension and realize that mystery is all around us today.

Mothers are People First

Mothers are People First

This was my Mother’s Day column in the Greenville News.

http://www.greenvilleonline.com/story/opinion/2017/05/12/mothers-day/101521348/

I have been graced by a long line of mothers. I had two grandmothers who loved me dearly, and who (though they have passed from this life) remain dear to my memory. My own mother Sharon was, and remains, a wonderful woman who raised me gently and with endless help and encouragement. My mother-in-law Carma has ever been kind to me, and treats me like a son.

My wife Jan is an incredible mother, who has dedicated her life to our children, going so far as to homeschool them for many years. She is indulgent and patient with them and they are always in her thoughts and fervent prayers. She is a Godly mother like all of the mothers in my life.
Having praised these women, let me say something shocking that we forget all too often on Mother’s Day. Although we seem to have a ‘cult of mama’ here in the South, mothers are just people like all the rest of us. They are capable of love and hatred, they can be supportive and destructive. They may lift their children up or tear them down. (Both the stuff of various books and movies.) They have good and bad days, and decades. Mothers were once mere girls, then they were lovers or wives. Along the way they accumulated hopes, dreams, stories, successes, failures and wounds of their own.
Because they were not born mothers, but become mothers, they bring all of these things with them when they bear, or adopt, children. So into the wonder and chaos of motherhood they bring their humanity. And humans, mother or other, are imperfect.
These imperfect people we call mothers are often subject to some nasty treatment. Sometimes, we confine them to their maternal roles. As if all they are capable of is producing and raising kids for the future. Jobs? Degrees? Achievements? Passions? Irrelevant, as some women are subordinated to motherhood by their families, and are not encouraged to attain the full glory of the various reasons for which God put them on the earth.
On the other hand, modern society often says to moms, ‘sure, you can choose to be a full-time mother, but what a disappointment you’ll be to all of the women of the world! Career and education are so much more useful and interesting than caring for mere children! What a waste of your potential!’ As if raising human beings, loving and caring for them, were no more exciting or important than having fish in an aquarium. While ‘choice’ is a powerful mantra, the choice some women make to focus on motherhood is sometimes unfairly viewed as failure.
The third option is perhaps cruelest of all. It tells mothers to be everything. Raise perfect children, and feed them lovely, healthy meals, engage them in all activities and make them super students. Simultaneously, rise meteoric through the corporate world! Never say no to a new project, a new goal, a better job! Stay thin and beautiful and do all things as they appear in glossy magazines. ‘Bring home the bacon, fry it up in a pan,’ or else be a pathetic loser.
Mothers, meanwhile, struggle with just being people. Like everyone else they have fears and anxieties, sorrows and addictions, illnesses mental and physical. Some mothers are close to ideal, others will wound the ones they bore. Some, overwhelmed by their own troubles, simply cannot raise children, while others make it look effortless. There are those mothers who are stars in business, government, professions, athletics or other fields. And yet, all too many never have good jobs or educations. Some mothers land in jail.
The thing is, mothers are are neither gods nor angels. And it is cruel of us to expect them to be either. They will not always accomplish everything they dream of and sometimes their children will be less than they had hoped despite their best efforts. Sometimes children will be disappointed with their mothers, fairly or not. This is reality. This is life in a fallen world.
In the end, we should celebrate the many gifts and sacrifices of all mothers. Simultaneously we must remember that mothers deserve, as do their children, to be loved for who they are. And given grace despite who they are.
So love your mom this Mother’s Day! But along with dinner, flowers or the assorted gift offerings you bring, give her the freedom to be perfectly imperfect. Just like you and just like me.
Happy Mother’s Day moms!

Emergency Medicine: a Model for Unity

This is my April EM News column.  I hope you enjoy it!

http://journals.lww.com/em-news/Fulltext/2017/04000/Life_in_Emergistan__A_Model_for_Unity_and.12.aspx

How do you define yourself? How do you describe yourself? In the past, I have tried to avoid immediately categorizing myself by my profession. I always agreed with The Little Prince:

“Grown-ups love figures…When you tell them you’ve made a new friend they never ask you any questions about essential matters. They never say to you ‘What does his voice sound like? What games does he love best? Does he collect butterflies?’ Instead they demand ‘How old is he? How much does he weigh? How much money does his father make?’ Only from these figures do they think they have learned anything about him.”
-Antoine de Saint-Exupery, The Little Prince.
Taken from https://www.goodreads.com/work/quotes/2180358-le-petit-prince

And yet, we do this constantly. Physicians especially love to divide ourselves into groups. Each group has its own characteristics. Most of those reading this (but not all) are EM docs (ER docs if you’re older), also known sometimes as ‘pit docs.’ There are internists, or fleas. Surgeons, or cutters. Anesthesiologists, or gas passers. Pediatricians, or pediatrons. Radiologists, or shadow doctors. Orthopedists, or carpenters. (I kid!) This is a natural division as our specialties are our big, nerdy fraternities and sororities. They are the places we learn to make our living, establish habits of thought and behavior, create world-views and life-long friendships.
Unfortunately, it goes much further than specialty. We are divided between rural and urban, and there are significant problems in that chasm, as physicians in urban teaching centers sometimes have little knowledge of the stark limitations of the rural setting when we call for help or transfers. ‘You don’t have a surgeon? You don’t have an ICU?’ Likewise, rural physicians often forget that even ‘the big house,’ eventually reaches capacity and can’t take transfers; and the presence of the large center (or a helicopter) is no excuse for sloppy care on the outside.
We are also demarcated by into ‘community vs academic.’ In my medical wanderings over the past few years, I have found that this is a point of contention with many community physicians. Research, treatment pathways, algorithms, check-lists and new imperatives seem to constantly emanate from academic centers and flow to the community hospital and its citizens. Community physicians, many of whom have lived through countless swings of the medical pendulum and associated policy changes, are often reasonably skeptical of the latest study, the latest rule about pain medications or sepsis protocols. They feel cut-off from what they perceive is a connection between academics and policy-makers, and they feel particularly excluded if, later in life, they have an interest in entering academia, which seems like a closed club.
Physicians are also increasingly divided by gender and sexuality, as we see various physician advocacy groups pop-up. That’s fine, I suppose, so long as it doesn’t split us further apart but serves as a source of encouragement and connection for the members of those groups. (It becomes toxic when it is used as an exclusionary tool. I was told once that my opinion in a debate was less relevant because I was a ‘straight white male.’)
However, our divisions seem to be at their worst when it comes to politics. And it’s a pity, really, because we have such potential to be models for the rest of the world. I have seen physicians argue politics in person and online. I have been part of some of those debates, and it can be very, very ugly. I have recently withdrawn from most political dialog because it wastes time, causes anger and accomplishes nothing.
But I will give this ‘opinion’ and stand by it. I’ve worked with physicians who were Christian like me, Muslim, Hindu and atheist. I have worked beside ardent progressives and hard-core conservatives who make me look like a socialist (and that’s tough to do). I have worked with physicians who were gay and straight, rural and urban, academic and purely clinical. I’ve laughed and cried with them, eaten with them, encouraged and been encouraged by them. And I’d do it all over again. Because when it comes to our job, our real job of treating the sick, easing suffering and saving the dying, all of our differences evaporate into vapor.
So identify yourself by whatever category you wish. But never forget that we can serve as a model for unity, a model for the greatness of all free people, when we do our jobs well, and do them together for the good of others.
Now, what’s your favorite food? What’s your hobby? Tell me about your wife, husband and children. Because those categories interest me more than all the rest.

Pandora’s Pill Bottle. (A poem about the narcotic epidemic)

Pandora’s Pill Bottle

‘Patients who suffer from painful conditions
Should always be treated by caring physicians,
Who never forget to give good medications
For problems from fractures to awful menstruation.’

‘The fifth vital sign is your bright guiding light
The pain scale will lead you to do what is right,
So doctor remember to show some compassion
Since giving narcotics is now quite the fashion!’

Thus we were told for a decade or two
As patients stopped breathing and turned rather blue.
But hospitals loved their new high survey scores
And doctors were turned into pill-writing whores.

Yet things are now changing across the whole nation.
There’s blame all around and new drug regulations.
‘What were you thinking? What were you doing?’
‘How could this happen? Someone will start suing!’

In ER’s and clinics and every location
We docs shake our heads with increasing frustration.
We did what they told us despite all our fears
And Pandora’s Pill Bottle spilled out for years.

The pain scale betrayed us and caused too much trouble
The fifth vital sign is a big popping bubble.
The statistics we’re reading have left us quite nauseous.
So we’re trying new things to save lives and be cautious.

Dear doctors it’s you that must make these decisions!
Push back against administrative derision!
And when those ‘above us’ make policy errors
Stand in for the truth to prevent further terrors.

Can we Change our Minds?

It’s easy to be excited about facts when they support our own opinions. It’s nice to believe that uncomfortable facts are fake. Likewise, it’s comforting to believe that everyone who disagrees with us is ignorant. When the truth is so obvious, we say, how could anyone but an uneducated bumpkin deny it? And yet, it seems that much of our knowledge is incomplete and that our deeply held beliefs may be more fragile than we imagine.
I was thinking about this recently when I listened to a podcast about evolution. It was a discussion about some events that happened last November at the venerable Royal Society in London. It turns out that some well-respected scientists think that perhaps evolution isn’t just due to ‘random mutation and natural selection over time.’
According to some researchers at the meeting, our DNA is even more amazing than previously believed. It appears that external stressors change the way plant and animal DNA works so that creatures adapt much more rapidly than we thought. This doesn’t necessarily mean evolution is wrong; but certainly our understanding of it is probably incomplete.
This poses a challenge to some beliefs that have been held in exactly the same way by scientists, and the lay public, for a very, very long time. Can we handle the change in paradigm? Could we ‘adapt’ if we suddenly found out that evolution is a bit off? After saying for years that it was a not a theory but a hard fact?
The science of medicine changes all the time. For the past 20 years, physicians in training were taught that they should never hesitate to boldly give narcotic pain medication to patients who asked for them. Because after all, ‘why would anyone mislead their doctor?’ And who were physicians to judge? We were told, ‘you can’t create an addict in the ER.’
Except, according to some pesky researchers, it appears you can. Some people can become addicted after a very short course of pain medication. They’re just wired that way. And now pain pills and heroin are killing people in staggering numbers. Our venerable, white-coat clad instructors were wrong. (What? Physicians and professors wrong? Perish the thought…) And now we have to face the facts and change our behaviors as doctors.
New, intriguing information presents itself all the time in many areas of study. The bacteria in our guts may have to do with obesity and mental health. Litter boxes may contribute to human mental illness due to a parasite cats sometimes carry. Socialism in Venezuela is a disaster. Foreign aid sometimes worsens international crises. Who knows what’s next?
But what if we discovered a slam-dunk gene for religious faith that was so powerful that those who had it couldn’t help but believe? Could their detractors still regard them as simpletons or haters? What if we learned that the absence of that gene made for equally solid atheists? How would we believers treat them? What if some transgender people really have a body dysmorphic problem like anorexia? Or that there is a genetic marker that indeed makes them identify with another gender? What if discussing it isn’t hatred, bigotry or compromise, but compassion? What if we find, someday, that the science of climate change isn’t settled?
Obviously science advances. We love that idea until it bumps into us. What do would do when science, or new historical information, or some other new finding puts our personal beliefs in question? Can we let go of our political correctness? Or religious rigidity? Can we stop calling our opponents rude names? Are we OK with new facts when they contradict ideas dear to us?
It’s hard to let go. But just as we look back on our ancestors and smile about their quaint beliefs, someone will eventually do the same to ours. It will likely be the case that we were wrong about many things in ways we could never have imagined.
As times change and knowledge grows, we should all be a lot kinder in the way we view the opinions of others and cautious in the way we view ours own. Today’s unassailable fact could become tomorrow’s flat earth. A little humility, a little willingness to open our eyes and the courage change our minds, are probably in order all around.

In an Age of Terrorism, do Something!

Here we go again.  In London three are dead and many injured thanks to the low-tech use of a car and knife in yet another act of cruelty and cowardice in the name of terrorism.  If you’ve been on a retreat, in a coma or hiking the AT, here’s a link:

http://www.bbc.com/news/live/uk-39355505

Brits rise up in unity and solidarity, etc.  Great.  We should all show unity and solidarity.  But we should all be able to DO something since the political class as a whole, around the world, seems to think the whole terrorist thing is like a teenage phase and has nothing to do with any particular belief, ideology or policy.  Witness the endless handwringing we usually see as police and officials struggle to figure out the attacker’s motivation.  ‘Gee, what could it be?’

Fortunately, the Brits have put more police on the streets.  ‘Armed and unarmed.’  It’s a great strategy really.  One of the dead was an unarmed police officer who clearly distracted the attacker and absorbed the knife so that others could use, you know, weapons to aid him in his pursuit of martyrdom.

I rant on.  But what I want to say is this.  We individuals cannot predict terroristic acts, and we certainly can’t stop them before they start. That’s the job of law enforcement and the military.  We can only do what we can, when these events happen, if we happen to be present.

So I’ve been thinking about things people should know how to do.  First of all, we should know how to PAY ATTENTION!  I have recently seen a commercial for a cellular company in which a young man streams movies and TV everywhere he goes, on the street, on the sidewalk, on the bus. The world around being, apparently, just too boring.  This is dangerous.  We should watch and learn.  Is that a suspicous package?  What does it mean that smoke is coming from under the hood of that parked car in the crowded area?  Is that a real gun the scary man pulled out?  Or is it just an oddly shaped, giant cell-phone? Why is that gentleman speeding towards me on the sidewalk?  Wait, am I on an episode of Impractical Jokers?  Paying attention to danger leads to running or fighting which leads to being the guy interviewed the next day about what happened, instead of the one remembered as ‘a really great guy who will be missed.’

We should also read.  Learn, from news, books, websites and classes, how to identify concerning behaviors and situations.  What does a firearm sound like?  What does a bomb blast look-like? (Clue, TV and movies get it wrong a lot.)  It’s easy to hear or see something dangerous and immediately think it’s nothing; we want it to be nothing, after all.

One of the sites I visit is Active Response Training. They have lots of articles about self-defense, as well as reviews of mass terror events, etc.  They also have excellent classes; I’ve taken one myself many years ago.

http://www.activeresponsetraining.net

Furthermore we should stop being lazy slugs and get in shape.  Sheesh, America, there are lots of great reasons to be fit; being attractive to your mate or potential mate is a good one.  So is living long and staying away from ER doctors like me.  But another is that when you are fit, you can run and fight.  This isn’t some right-wing way of looking at things.  It’s called an ‘evolutionary advantage.’   Run, bike, lift weights, hit the punching bag.  Do it until you’re exhausted then do it some more.  Say it with me:  Fitness = Survival.  It isn’t hard.

As a child I loved the Chuck Jones cartoon production of Rudyard Kipling’s mongoose story, Rikki-Tikki-Tavi.  In the movie, Rikki the Mongoose says:  ‘A fat mongoose is a dead mongoose.’ That is, a fat mongoose can’t fight poisonous snakes.  I’ve never forgotten that lesson. Thanks Rikki!  And thanks Mr. Kipling!  (Not sure if it’s in the book, but the cartoon message really impacted this kid…)

13171105

So what else can we do in an age of terrorism?  Emergency physicians like me understand  how to manage serious injuries, but we need to encourage citizens to learn 1) first aid with hemorrhage control and 2) CPR.  CPR classes are everywhere and typically include use of Automated External Defibrillators or AED’s.  In fact, in trauma situations like those involving terrorism, CPR and AED’s are probably not going to be very useful.  But it’s good to know for other sorts of emergencies.

DHS has a website and initiative called ‘Stop the Bleed.’  It’s worth a look as there are training videos.  Many companies also sell bleeding control kits that citizens can, and I think should, keep in their vehicles or on their persons.  A tourniquet and dressing don’t take up much space.

https://www.dhs.gov/stb-learn-how-stop-bleed

I would encourage young people to consider taking local First Responder or EMT basic classes.  It’s information you’ll never regret having, and it looks great on a resume.

We need a veritable army of first responders out there, ready to help while police and EMS are either tied up, on their way or being attacked themselves.  Physicians should be part of the effort to teach this material as well.

Last, but not least.  Those so inclined should learn to fight.  Obviously, the average person isn’t Rambo or an Army Ranger.  Most of us will never be up the the level of an MMA fighter.  But it may not take all that.  MInd you, self-defense classes can be absolute crap.  Especially the stuff they foist on nurses and physicians in order to handle attackers and dangerous patients (since security is usually told not to touch anybody…).

And self-defense skills need repetition like all motor skills.  But those people who want to learn can learn.  Learning to fight, whether boxing, wrestling, martial arts, etc., is hard, painful work.  It isn’t for everyone.

.However, sometimes, it takes just a willingness to do something, or anything. I saw a video this week in which a citizen and CWP holder shot, and killed, a man who was holding down a police officer and beating said officer badly.  Now, he was armed with a pistol, but might just as well have used the shovel I keep in my truck to hit the guy on the head.  Or might have thrown a rock.  Or picked up a stick.

In a building, a fire-extinguisher might be just enough delay and distraction.  A can of wasp and hornet spray kept in the office is mighty nasty stuff if sprayed in the face.

If so inclined, as many of us are (and far more physicians, nurses, medics, etc. than you might imagine), carry (legally) a firearm or reasonable knife.  If the attacker is bent on killing you anyway, can you do worse than fight?  You may slow him (or her…sorry). You might keep them from killing anyone after they kill or maim you.  Or, if you’re in good shape and have trained in some sort of class or fighting discipline (or just get really lucky…or have angels fighting with you), you might win!  Sure, sure, people will call you a monster.  But lives will be saved.

It’s a dangerous world, and always has been. But there are things we can do to make it less so.

Sitting back while the danger grows with our fear, apathy and inability?

Those are just bad options.

So:  Put down the phone, pay attention, read and learn, get in shape, learn to help the injured and learn (or at least consider) how to resist.  America, heck, civilization, needs this now more than ever.

 

 

Back Pain, a Prisoner and a Lenten Reminder of Mercy

chains-19176_1280

 

She was large, and heavily tattooed.  She was in a striped uniform with handcuffs, her feet shackled. She sobbed because of her back pain.  Her life a long history of mistakes and bad choices; alcohol, drugs, criminality.  Her family, husband and children, a victim of her lifestyle, her addictions, her misdeeds.

They can’t have narcotics in jail, and in fact, narcotics don’t have much role in back pain, we’re finding.  But in jail, she lay on a thin mattress on a concrete pad.  Getting up and lying down were, she said, agonizing.

Was she lying?  Her drug screen positive for amphetamine, it was possible.  The officer with her said, ‘I’ve known her for 15 years.  This is her. Crying and moaning. But what if she really has pain?  It’s tough doc.’

It’s tough for sure.  Knowing as I did that if she went back to jail, she might really be suffering. Knowing, also, that she had a reported history of heart disease even though she was only  in her 30s.  Knowing that she would surely come back with chest pain or back pain, legitimate or illegitimate, if nothing were done.

Ultimately, after two visits, she seemed worse.  She seemed to have difficulty standing.  Her sobs continued.  Her officer and I sympathetic but worried about being tricked.  She was given pain meds and transferred for an MRI.  Maybe there was something going on in her spinal cord. Maybe a hematoma, maybe an abscess.  Who knew?

Here is the conundrum of compassion, as it were.  The compassionate will be cheated, fooled, and lied to.  This is life in the ER. This is life on earth.  The right thing is often, in the rear-view-mirror, exactly the wrong thing, as those who fool us laugh and drive away.

But we have the last laugh.  Because the right thing is just that.  The right thing.  And it’s a great lesson here in the Lenten season.  To show kindness, to give mercy, to expect to be the butt of the joke, the patsy, these are all the ‘price of doing business,’ when our business is being like Jesus.

I believe she had pain, but even if she lied to me, even if she gamed me, it’s OK.   I’m not offended.  She was vulnerable. She was wounded. She was broken.  She was a prisoner. And here’s what Isaiah, God’s prophet, said about captives and prisoners.  And notice, no mention of guilt, or of punishment deserved or earned.  Isaiah 61: 1-3

The Spirit of the Sovereign Lord is on me,
because the Lord has anointed me
to proclaim good news to the poor.
He has sent me to bind up the brokenhearted,
to proclaim freedom for the captives
and release from darkness for the prisoners,a
2to proclaim the year of the Lord’s favor
and the day of vengeance of our God,
to comfort all who mourn,
3and provide for those who grieve in Zion—
to bestow on them a crown of beauty
instead of ashes,
the oil of joy
instead of mourning,
and a garment of praise
instead of a spirit of despair.
They will be called oaks of righteousness,
a planting of the Lord
for the display of his splendor.

Jesus said the same thing at the beginning of his ministry.  Luke 4: 16-21.

Jesus returned to Galilee in the power of the Spirit, and news about him spread through the whole countryside. 15 He was teaching in their synagogues, and everyone praised him.

16 He went to Nazareth, where he had been brought up, and on the Sabbath day he went into the synagogue, as was his custom. He stood up to read, 17 and the scroll of the prophet Isaiah was handed to him. Unrolling it, he found the place where it is written:

18 “The Spirit of the Lord is on me,
because he has anointed me
to proclaim good news to the poor.
He has sent me to proclaim freedom for the prisoners
and recovery of sight for the blind,
to set the oppressed free,
19 to proclaim the year of the Lord’s favor.”[f]
20 Then he rolled up the scroll, gave it back to the attendant and sat down. The eyes of everyone in the synagogue were fastened on him. 21 He began by saying to them, “Today this scripture is fulfilled in your hearing.”

In this passage is healing and liberty.  And nobody is a ‘jailbird’ or ‘scumbag’ or ‘crook’ or ‘junkie.’  Jesus wants to offer this to all.

This Lenten season, can I do any less?  I, a captive of sin as all of us are, delivered and healed? I with blind eyes, seeing clearly thanks to my redemption?  God knows if I lie to him, if I try to trick him. And loves me anyway.

And if it takes showing mercy to the meth-using prisoner with back pain to honor the mercy I received, well it’s a small price to pay.

Edwin