Fighting drug abuse in the ER

Fighting Drug Abuse

My latest column in the Greenville News.

http://www.greenvilleonline.com/story/opinion/contributors/2016/04/09/commentary-fighting-drug-abuse-er/82713082/

I have a lot of ER stories that involve drug addiction and drug seeking behavior. I knew a patient who intentionally dislocated his shoulder three times in one day to receive pain medication. Another had a friend who stole an entire dirty needle box in order to rummage through it for injectable drugs.
I have been told by patients that pain pills were eaten by dogs, stolen by neighbors, lost in car crashes, accidentally flushed down toilets and all the rest. People have pled with me because their normal doctor was out of the country. One individual (call him Bob) came to me and was denied narcotics, then returned two hours later with a woman’s ID and saying he was she (call her Carol). ‘You aren’t Carol, I just saw you.’ ‘Yes I am, I’m Carol and I’m in pain.’ ‘Get out,’ says I. The list goes on and on and every physician has a few of his or her favorites.
In the annals of American medicine, it turns out this was all rather new territory, at least in scope. My career began in the early 90s when there were (for various reasons, corporate and otherwise) powerful initiatives encouraging us to treat pain with more narcotics pain medications like Lortab, Vicodin, Percocet and others. We were regularly scolded for being cruel and insensitive about people’s pain when we, young and innocent as we were, expressed discomfort with this practice. I remember being explicitly told, more than once, ‘you can’t create an addict in the ER.’
We were told that pain was the ‘fifth vital sign’ and were taught to use a ‘pain scale,’ which you’ll hear to this day whenever you interact with the healthcare system. ‘What’s your pain on a scale of zero to ten with zero being no pain and ten the worst pain of your life.’ Most nurses can say this in their sleep. We developed smiley face scales for small children to use.
We learned to give narcotics regularly for various types of pain, when they had been previously reserved for cancer, long bone fractures or significant surgeries. Medical boards were encouraged to discipline doctors who were reported to under-treat pain. And hospital administrators, ever in love with the ‘customer satisfaction’ model, pressured physicians whose patients complained about receiving inadequate pain treatment. (High patient satisfaction scores have been studied and associated with poor outcomes, by the way.)
Although it’s difficult to quantify because physicians feared for their jobs, I’ve spoken to many physicians over the course of my medical and writing career who were told by their employers to give narcotics when requested or risk loss of income or of employment.
This happened even in the face of staff who knew the abusers. We used to keep files so that even new physicians could tell who the problem patients were. Eventually, we were told to stop. It was a kind of profiling and it was unacceptable. Always assume they’re telling the truth, we were told.
Sew the wind, reap the whirlwind. Since 1999 prescription narcotic overdoses soared, quadrupling over the period to 2014 according to the CDC. Over that period there were 165,000 deaths from prescription opioids, most commonly Hydrocodone, Oxycodone and Methadone. In 2014, over 14,000 people died from those drugs.
Now, the move is from condemning our insensitivity to questioning our judgement. Prescription drug abuse is a high priority for state and federal law enforcement, state medical boards, the Drug Enforcement Agency and The Centers for Disease Control (which recently released new, more conservative guidelines for chronic pain treatment).
States are using online prescription monitoring programs and many hospitals are putting policies in place to give as few narcotics as possible in emergency departments. It’s a Catch-22 of course, as some patients with legitimate pain are told to find pain specialists or family doctors, when they either have no money to do so, or have no physicians in the area taking patients. Thus, they circle back to the ER where we try our best to remain both diligent and sympathetic.
Physicians and hospitals are now engaged in a constant battle to combat drug abuse, to save lives and help empower the families of those struggling with addiction, who are desperate to help their sons, daughters, husbands and wives.
I hope we maintain our compassion. But I also hope that it keeps getting harder to walk into an office or ER and get addictive, lethal prescriptions.
Because it’s time for this nightmare to stop.

 

 

If this is an emergency, hang up and dial 911…

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Currently, in American healthcare, experts are wringing their hands in confusion.  I mean, people have insurance, right?  And yet, healthcare is still expensive and dang it, people just keep going to the ER.  Visits are climbing everywhere and I can speak from personal experience when I say that we’re tasked with more and more complex and multi-varied duties in the emergency departments of the 21st century.

I’m not a medical economist.  I do have some thoughts on the well-intentioned but deeply flawed Affordable Care Act. However, I won’t go there right now.  What I do want to address is the ‘go directly to the ER’ mentality of modern American medicine.

Call your physician.  If it’s after hours, the recording for any physician or practice of any sort in America will have a message:  ‘If this is an emergency, hang up and dial 911.’  It’s a nice idea.  But of course, it presumes that everyone really understands the idea of emergency.  In fact, they don’t.  We understand that, or we try to, but we see lots of things that come in ambulances, or just come to the ER, that really aren’t.

‘I feel fine, but my blood pressure is up.’

‘I was bitten by a spider and I watch nature shows and I know how dangerous they are.’

‘I have a bad cold and I have taken two rounds of antibiotics.  I have an appointment with my doctor tomorrow but I thought I’d just come on in to get checked out.’

The list goes on.  In part, it’s because we do a poor job of educating people about their bodies and their illnesses.  Online searches usually result in someone self-diagnosing Ebola or cancer, so that doesn’t help much.

But in part, it’s because the ER, the ED, has become the default.  Surgical patients are told to have wound rechecks in the emergency department.  Kids with fevers are directed there by pediatricians or family doctors or secretaries.  People who need to be admitted are sent in ‘just to get checked before they go upstairs.’  Or sometimes, so the physician on duty can do the negotiation with the hospitalist, rather than having the primary care physician do so.

Why is the ED the default? In 1986 Reagan championed and Congress passed EMTALA, the Emergency Medical Treatment and Active Labor Act, which says you can’t turn anyone away for reasons of non-payment.  Another well intentioned bit of government meddling, it never provided any funds for it’s expansive act of compassion so many emergency departments and trauma centers simply shut their doors.  You can’t see patients for free all day and still meet your budget.  I think something needed to be done, but it probably went too far.

Fast forward.  Insurance is expensive even when the government mandates it. Whether for fear of litigation or due to over-booked schedules everyone else can always send patients to the ED day or night for any reason.  We still function under EMTALA and that will never, ever change.  Patients have little to no expectation of payment when covered by Medicaid and know it (and thus use the ED for everything, and I mean everything.  We are seeing expanding life-spans for the elderly, but with more complex illnesses being treated and ‘survived.’   We have fewer and fewer primary care providers.

Who actually thought emergency department visits would decrease, and why?  Did they ask anyone who saw patients on a daily basis? Or only lobbyists, administrators and progressive academics with starry-eyed fantasies?

I want to take care of everyone. But the Titanic that is emergency medicine in America is sinking.  We really, honestly can’t bear the burden for all of the chaos of our national healthcare.  And don’t tell me that if we have a single payer system it will change everything, because it won’t.  EMTALA will go on and doctors paid by the feds will not be more productive than they are now, so everything will still flow to the emergency departments and trauma centers of the land.

This isn’t about rejecting the poor, or even criticizing Obamacare.  It isn’t about single payer or Medicare for all. It’s about entrenched behaviors and facing the reality of the system we’ve created which allows one part of the system to attempt to carry the limitations of the rest.

Herb Stein, father of Ben Stein, famously said:  ‘If a thing can’t go on forever, it won’t go on forever.’

And if its’ true anywhere, it’s true in the emergency departments of this great land of ours.

Where the answer to every crisis is: ‘hang up and dial 911.’

We should value each other more than politics

http://www.greenvilleonline.com/story/opinion/contributors/2016/02/26/value-each-other-more-than-politics/80922306/

Allow me to spin tangentially off of politics for a bit, if you don’t mind. (I promise to bring it back around.) After all, I suspect even the most passionate political advocate would welcome some news coverage of an alien invasion or a cat that speaks French, or anything just to take our minds off of the endless drone of political conversation. I feel like Bill Murray’s character, Phil Connors, in the classic movie, Groundhog Day. ‘There’s no way… this winter (or election)…is ever going to end.’
Instead, I want to talk about perspective. Many readers and friends will recall that five short years ago my wife Jan had a metastatic throat cancer. She endured some pretty miserable radiation and chemotherapy. After that she had a large pulmonary embolus (blood clot in the lung) which put her into intensive care and scared us all.
Over time she recuperated fully and our family went back to life as before, but with some incredible perspectives on the value of life, love, health and the inevitable passage of time. She recently had her last oncology visit and was released. Like a cat tip-toeing on wet grass, the years crept up on us and the thing we hoped and prayed for arrived at last, with less fanfare and perhaps more joy than ever. This year we celebrate her 13th birthday, on February 29th, seeing her as the treasure she is.
The great insight here is that all of our battles, won or lost, illustrate an often neglected fact. Which is that however much we may care about elections or economies or all the rest, the real joy and pain of life circles around that person, or those persons, we love the very most. And anything that makes life better for them, or us, probably won’t come from any elected official of any party but will mostly be the fruit of individual effort (and insight) motivated by intimacy and love.
Indeed, those who govern us have their effects, but hour to hour, day to day, year to year, they remain (quite expectedly) unfamiliar with the unique issues of the many and varied lives of their citizens. We, who love one another year to year, hour to hour, day to day, are best suited to improve the lives of our friends and family members, simply by holding them close in life’s assaults.
Happily, this election too, shall pass. Winners and losers will rise and fall, switch places and mostly end up as impotent to steer the ship of state as all those before them. Scandals will strike, accusations fly, a few good things will result and standard political doldrums will likely set in as always. The political pendulum will pause and swing back and forth as it has for ages, with utter disregard for our messianic political prophecies.
The future will come however we fret about the present. In the end, we will (hopefully) leave behind all of our invective, our screaming, our memes, rallies, slogans and our absolute conviction that a particular candidate will end or miraculously transform life as we know it. We’ll simply move on, as all humans do, to new idols. We’ll then cast the current objects of veneration on the dust-bin of history.
Perhaps, if we are attentive, we’ll then see that the things we dread about the future rarely come to pass at all and suddenly, five years, or ten, will pass and we will still be here, expecting the worst. All the while, of course, living in what is possibly the best time to be human in the history of the world. Many of the things that seemed so immediately critical will probably fade and many of the things that really mattered will remain despite the way we ignored their value. Then we can move forward…till the next election!
Ah, but those we love! Their troubles and victories will remain. Our shared joys and struggles will go on, bonding us together as no election ever could, motivating us far more than any party. They are the arena, they are the causes and campaigns where we make the most difference. They the ‘candidates’ who need and deserve our endless, unwavering devotion and sacrifice.
In our deep need to follow, let’s never forget to follow most closely the ones entrusted to us in the daily trials and wonders of ordinary life.

 

We can’t go it alone; a lesson for an election year.

One of my Christmas gifts was a book by Lewis Dartnell titled ‘The Knowledge: How to Rebuild Civilization in the Aftermath of a Cataclysm.’ The goal of this book is to serve as a kind of basic repository of the things humans would need to know if society came crashing down and we had to rebuild our civilization and our technology.

I love knowing how things work. I think I would have enjoyed taking engineering classes; except for the fact that I’m intellectually stuck somewhere around Algebra I. I’m fascinated by electricity and airplanes, by bulldozers and cell-phones and all the amazing things humans have made.

Since I’m a physician, I often think about how little I could do without all of the wonderful things that science and industry produce for me to use. Something we take so for granted, like Penicillin, was discovered, developed, produced safely in mass quantities and distributed in ways that made (and continue make) life better for literally billions. And that’s just scratching the bare surface. Medicine is wonderful because we have drugs, devices and procedures to make it so. If those things suddenly went away, the world would be a darker, sadder place.

Dartnell makes the point that for a while after the collapse of society, we’d still have lots of ‘stuff,’ and might be able to live comfortably on the remains of the world that unraveled before us. But in time, we would have to start making things, growing food, developing ways to manage clean water and sewage. We would want electricity, we would need transportation and machinery, unless we simply wanted to revert to a kind of primitive existence. That sort of ‘noble savage’ life always sounds fun until you go camping with small children for a week, after which you’d give a kidney for a hot shower.

What really got me, though, was the way the author pointed out that most of us, as individuals, can’t make much of anything even now! Granted, some are better than others, and doubtless there are those amazing people who can make a gas engine from an erector set and toilet paper roll. But on the whole, we can’t and we don’t.

If you doubt me, look around your house and ask how you would make a new refrigerator, how you would repair broken furniture, how you would get water if the supply stopped, and how you would heat your home on a cold night. Then, ask yourself how you would manage to make toilet paper, where you would get fresh vegetables and if you could, or would, be willing to kill an animal to eat.

Currently, someone does those things for you, for me. I am humbled to realize that we are so profoundly interdependent. We need each other far more than we realize, or admit. The man who built my house needs my expertise on medical care, and I don’t know anything about construction or carpentry. My children need professors who know things I can’t begin to understand, and those professors need mechanics to work on their cars. And good heavens, do we ever need farmers to grow our food and truck drivers, train engineers and pilots to deliver goods! The farmer needs the researcher to tell him how to get a higher yield. And just how do those guys work on electric lines in the dark stormy nights to return our power to us? We all need them, as we need those who produce the electricity they help deliver.

We all need bankers and investment specialists to manage money in a complex market and they, in turn, need firefighters, paramedics and police officers to keep them safe. We all need our soldiers to keep us secure, and they have little time to do much of anything else and need us too.

The list is almost endless. And in an election year, this is really important. Because we divide ourselves during elections. We point fingers and call names. I do it, and so do many others. But perhaps the most important thing we can do is remember our tightly woven, almost biological links to one another. America is a living organism that needs all of its parts to work together. Party affiliations aside, ideology aside, a thriving society requires connection like a body needs nerves and blood.

Perhaps the best leaders are those who recognize that for all of our frustration and animosity, none of us can go it alone.

Which Veteran’s Are We Celebrating, exactly?

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I found this advertisement recently.  It was a very kind attempt to honor veterans by giving them free haircuts.  I have intentionally blacked the name and address of the salon.  I mean no ill will.  It’s just an observation.  However, there’s a problem with this flier. It jumped out at me instantly.  Maybe because I played with lots of toy soldiers as a child.  Perhaps because I’ve watched a large number of war movies.

Or it could simply be because I am passionate about history.

What’s the problem?  I mean, someone made a very colorful hand-bill and then found the word soldier, or veteran or something like that and pasted the image as homage.

Many of you have already figured it out.

It appears to be a drawing of Russian Red Army soldier.  Not an American soldier.

Not that Russians or Commies don’t have veterans that they honor.  That’s their business.  But here, an image of an American veteran, past or present, might have been a wee bit more appropriate.

It’s little things like this that remind me that history matters and that all too many Americans don’t really pay attention to it.

Happy Veteran’s Day, ladies and gentlemen!  Thank you for standing for freedom.

 

Jesus wasn’t about right or left. My column in today’s Greenville News.

My column in today’s Greenville News. 

Jesus wasn’t about right or left.

http://www.greenvilleonline.com/story/opinion/contributors/2015/10/09/ed-leap-jesus-right-left/73665540/

These are contentious times when it comes to the junction of religious faith and politics. Whether the issue is poverty, same-sex marriage or abortion, there is remarkable division even within the Christian world. This is evident in the fact that people often refer to, or ally themselves with, the ‘Christian Right’ or the ‘Christian Left.’

It’s a fascinating discussion, and indeed, Christians do have political leanings that vary widely. Some are dedicated, hyper-conservative fundamentalists while others feel that Jesus was a kind of ‘proto-communist’ and we should all be the same. Christianity can, in fact, be a rather malleable belief system. And like all ideologies it can be twisted to justify good and bad with equal fervor.

This is all fairly evident in the response to the US visit by Pope Francis. People on the left side of the faith are thrilled that the Pope is concerned with climate change and income inequality. Those on the right hope that he can overcome his Argentine bias against capitalism and see what a functional middle class, and a nation with safety nets for the poor, actually looks like. They also dream that he will speak boldly about the horrors of abortion. Both sides have ‘a dog in the fight.’

The thing is, we all have it wrong when we become a faith of factions. We all have it wrong when we make it about politics and not Jesus. When conservative Christians (like myself) fall in love with war for its own sake, for the power and domination, for the intimidation and machismo of it, we forget the Jesus who loved even the enemies who crucified him. When we fail to be sympathetic to the sick and broken, we neglect the Jesus who touched lepers and healed the blind and fed the 5000. When we love money and success as ends in themselves, we become deaf to the master who reminded us that the journey to heaven is nearly impossible for those carrying bags of earthly wealth. When we believe morality is an end in itself, we abandon the Jesus who came to bring redemption and deliverance from our inevitable sins. We must try our best not to be ‘conservative’ or ‘right-wing’ Christians. We must only be Christians.

But when liberal Christians focus only on patching the wounds of this transitory existence by shifting money or passing laws, when they scoff at eternity and eternal consequences, they lose sight of the Jesus who told Pilate, ‘my kingdom is not of this world.’ When they say that Jesus was merely a radical thinker who came to teach us acceptance not transformation, who came only to compel us to ‘be nice’ and not judge anyone (not even our own sins), then they turn their backs on the loving teacher (and ultimate judge of all, according to scripture) who lived and taught morality and who promised to transform us into something far better than what we are. The very Jesus who had hard words for every kind of sin, including sexual sin as well as greed, lies as well as hatred, and who spoke about hell and judgment extensively, even as he promised to rescue us from both.

Furthermore, when any flavor of Christianity reshapes Jesus to be more acceptable to popular culture, they forget that He said to his disciples, in Mathew 24:9 ‘Then you will be handed over to be persecuted and put to death, and you will be hated by all nations because of me.’ Popularity, and popular acceptance of our beliefs, are not likely to happen if we truly live the way He wanted us to live.

We will certainly have varied opinions on politics and policies, and on the proper expression of our faith in our daily life and national politics But we aren’t supposed to insult or disdain one another. We should, rather, care for one another and see what we can learn by loving those who share our faith but differ in perspective.

Jesus himself, the night before his arrest, said it best. In John 17:20-21 he was praying for his followers, and then continued, ‘I do not ask for these only, but also for those who will believe in me through their word, that they may all be one, just as you, Father, are in me, and I in you, that they also may be in us, so that the world may believe that you have sent me.’

Not a word about right or left. May we all be one.

 

 

 

 

 

 

 

A Fresh New Fundamentalism Threatens America

My column in yesterday’s Greenville News. 

 

http://www.greenvilleonline.com/story/opinion/contributors/2015/09/11/ed-leap-face-new-threat-country/72078692/

 

If you haven’t heard the name Kim Davis lately, you’ve either been in a coma or stranded on a deserted island. If either applies to you, she is a county clerk in Rowan County, Kentucky, who refused to issue marriage licenses to same-sex (and straight) couples because of a faith-based stance against same-sex marriage. She was subsequently ordered to do so by a judge, continued to refuse, was jailed for contempt of court and then released.

She has become, in the eyes of many, the great Satan of American Christian conservatism. Unimaginable numbers of news stories, blog posts, panel discussions, op-eds, Facebook and Twitter posts and all the rest have been devoted to her. The majority of what I’ve seen are well-crafted to highlight the way in which she is a hypocritical Christian (who has been divorced more than once and has children by more than one father). Furthermore, photos of Ms. Davis are not flattering. She is, to cultural progressives, the perfect bedtime monster. She is seen as an overweight, unattractive, fundamentalist Christian hillbilly who dares to stand against both the courts and popular cultural opinion (emphasis on the second) on the issue of same-sex marriage. In other words, it’s perfectly acceptable to hate, and fear, her.

For the record, as the reader prepares an angry invective against me, I believe that Ms. Davis should have accepted the judge’s accommodation to remove her name from marriage licenses, or she should have resigned. Accommodations are compromises at the intersection of religious belief and work. Still, the law is the law and whether she agreed or not, she should have obeyed it. Render unto Caesar and all that.

Except, it doesn’t always work that way. For instance, sanctuary cities like San Francisco have officials who, on moral grounds, refuse to enforce federal immigration law. Four states have legalized recreational marijuana; thus, their state politicians simply choose to ignore federal drug laws. Anti-war protestors in the 60’s, civil rights activists in the South, radical environmental groups, all stood (or stand) against the codified laws of the time on moral (if not religious) grounds. In fact, there was a time when the granting of marriage licenses to same sex couples in California was illegal. It still happened. The furor over this issue, in light of other, more ‘acceptable’ instances of defiance, is a hypocrisy far more stunning than that of divorcee Kim Davis’ chaotic personal life.

Because of Ms. Davis, our country has again been warned of the incredible dangers of letting religion into politics. We are told that we can’t have people using government position or authority to force people to embrace a set of beliefs. Why, just think about the Christians of history and all of their cruelty towards non-believers! How horrible! Wait, that seems odd. Kim Davis was imprisoned for a belief. But remember, she’s a hick who deserves to be taught a lesson! I mean, just look at the pictures!

The most striking thing about this entire issue, and the cases of bakers and photographers declining to do same-sex weddings, etc., is that America, taught to be deathly afraid of people imposing their beliefs on others is now all about forcing beliefs on certain people. Comply, in public life and private, or be fined, jailed or asked to the door. Brendan Eich, developer of JavaScript and (among other things) Chief Technical officer and CEO of Mozilla, was forced to resign over a $1000 donation he gave, in 2008, to the California’s Proposition 8 pro-traditional marriage initiative. The Denver City Council may well refuse to allow Chic-Fil-A in the Denver International Airport because the company’s owners are opposed to same-sex marriage. The list goes on.

In truth, I’m much less worried about who marries who than I am about the religious and free speech implications that come along with same-sex marriage. And I’m far less concerned about Kim Davis being jailed than I am about the giddy delight expressed nationally by US citizens who want to see people punished for having the wrong beliefs.

Anyone who thinks this behavior isn’t the same as ‘forcing your beliefs down someone’s throat’ is simply choosing a new, shiny, post-modern fundamentalism. And First Amendment or not, it’s a dangerous and remarkably hypocritical way to run a country.

Human Trafficking; Closer Than You Think

This is my column in this month’s SC Baptist Courier.  If you have a subscription, here’s the link.

https://baptistcourier.com/2015/09/wholly-healthy-human-trafficking-closer-than-you-think/

One of the wonderful things about medicine is the insight it gives us into humanity on a daily basis. After sufficient time, a physician learns to see, simply in passing, signs of illness or injury in other people. Problems past or present jump out to our eyes. And in fact, as Christians we should develop similar skills out of love. Given that the church is called to be salt and light to the world, it makes sense for us to also serve as scouts, as ‘life-guards.’ As such, we should be constantly on the lookout for the oppressed, the suffering, those subject to cruelty and tyranny, violence and harm.

Unfortunately, in modern times one of the things we should be watching for is evidence of human trafficking. Tragically, all around the world human beings are bought and sold in enormous numbers as victims of such horrors. They are sold as sex slaves (forced into prostitution or other forms of sexual exploitation), as wage slaves (never making enough money to deliver themselves from unfair labor practices and contracts) and into frank slavery in everything from farms and factories to restaurants.

While victims of trafficking may not attend a worship service, there are other places where Christians interact with the public and where we might be able to identify, and report, those in distress. For instance, they might come to our food-banks or other church-related services like children’s festivals or community-wide parties. We might see them putting children onto a VBS bus, or simply observe them in the secular businesses where we work each week.

We can help identify these persons, and alert authorities, by knowing warning signs of human trafficking. The FBI offers a number of identifying characteristics (see also the link below): those who are victims may have no ID or money or documents. We may observe that they are closely watched and are highly controlled by others. It may be evident that they live in terrible living conditions and have poor clothing and nutrition. Furthermore, those who are victims of trafficking may report that they move frequently; or more likely be very evasive about any interaction. We should also be attentive to places where humans are behind locks and fences, or where persons have very long work hours and very little income. These same individuals may suffer wounds from abuse, work related injuries, or other illnesses for which they are not allowed to seek adequate care.

In fact, human trafficking is a problem of exploding proportions, and a business that is worth an estimated $150 billion per year worldwide which currently enslaves some 20 million humans of all ages. While in America, it typically involves foreign citizens trafficked into the US, the fact remains that about 33% of victims are US citizens. The great tragedy of human trafficking is that it preys almost exclusively on the most vulnerable of all citizens: the poor, the alien, the uneducated or undereducated, the weak, the young, substance abusers and those with mental illness. As Christians, this aspect should be particularly galling to us all.

And it should prompt us to learn how to diagnose this disease of humanity so that it can be identified, dealt with and ended.

https://www.fbi.gov/about-us/investigate/civilrights/human_trafficking

http://www.ilo.org/global/topics/forced-labour/lang–en/index.htm

The World Saw What Heroism Looks Like

This is my column in today’s Greenville News.  Go forth and be heroes.

http://www.greenvilleonline.com/story/opinion/contributors/2015/08/29/world-got-see-heroism-looks-like/71330336/

Last week, a Moroccan immigrant was on a train traveling from Amsterdam to Paris. He was armed with an AK-47 rifle, a Luger handgun, hundreds of rounds of ammunition and a box-cutter. A French passenger, three young Americans (one active duty Airman, one National Guard soldier fresh from Afghanistan and their civilian friend) as well as a 60-year-old Briton saved untold lives when they deduced that the heavily armed individual in their train car probably wasn’t out for a day of target shooting.

So, forming a committee they deliberated about the best course of action. They issued surveys to the other passengers on the train to make sure that they were in line with current cultural, political and economic trends. They posted their thoughts to Twitter and Facebook and took a short class on tolerance.

Finally, they contemplated their European privilege, and the ways in which they might well have personally caused the obviously oppressed and disaffected individual to want aerate the passengers with 7.62 x 39 mm ammunition and filet them with a razor blade.

No, I’m just kidding. The five rushed him, tackled him, disarmed him, beat him with his own rifle, John Wayne style and choked him unconscious. They then left him hog-tied, after which he was arrested and the injured heroes given medical treatment for the serious wounds they incurred.

Subsequently, the French media asked everyone to be concerned about the feelings of the poor terrorist, who was not at all responsible for his actions and who was just holding the weapons ‘for some guy.’ The men who attacked the unfortunate rifle bearer were held and their motivations questioned by gendarmes who consider Americans uncouth and barbaric. Charges were filed for disturbing the peace and for handling unlicensed illegal firearms (disarming someone is no excuse to touch a gun).

Nope, still kidding. The same week it happened, French President Hollande presented these heroic gentlemen with the Legion of Honour, the highest French award for heroism. I suspect that the five have been gulping down free champagne and dancing with hot French girls, even as their knees occasionally go week with the realization that they were each about one trigger-pull from eternity. But that’s what heroism looks like. And God knows the world could use some more of it.

During the tragic, fatal shooting at the recruiting station in Chattanooga over the summer, one or two active duty members returned fire with with personal weapons. There were serious discussions about the legality and propriety of this action and the Navy commander of the site may still face disciplinary action. Personally, I believe he deserves praise and honor. If he did shoot back, he did the right thing, at the right moment, when there was no time to ask for permission or contemplate the larger implications of the action.

We live in a difficult, troubled world. I believe that all free people should be able to protect themselves, because the police and military (God bless them) can’t be everywhere. Only when predators do not know who will resist, do not know who is armed or prepared, will they have reason for pause. But the issue for our time is far more than terrorism.

It is too often the belief that regular citizens should not be expected to protect the endangered, rescue the imperiled, contribute to the needy, feed the hungry, fight evil with force, free the slaves, educate the illiterate. That only through the inefficiency of government and the relative anemia of our own favorite politicians is good accomplished. But this is merely moral sloth; little more than the transfer of our own human duty to other agents (who care far less about our own problems than we), in order to assuage our guilt.

Most of us will never see, much less assault, a terrorist. However there is other heroism to be accomplished. We can give to the needy, comfort the hurting, educate and feed the children, visit the aged. On our own dime, and on our own time. It requires only the personal decision to act and the courage to sacrifice time and resources. Well, that’s not entirely true. We have to take time out from screaming at each other online and actually do something other than hoping for the next politician or election to make our ideological dreams come true or our wallets fat.

Ultimately, heroism comes in many incredible forms. But to act heroically we need (as the King said) ‘a little less talk and a lot more action.’

The dangers of a culture of feelings. (My latest Greenville News column.)

Bruce Jenner and the cultural peril of ‘feelings.’

http://www.greenvilleonline.com/story/opinion/readers/2015/07/18/ed-leap-danger-culture-feelings/30303603/

One of the great things about Christianity is that Christians like myself are endlessly challenged. In this modern, ever skeptical world, Christians truly have to ‘sink or swim.’ While some believers are troubled or offended by this, I say it is a gift. And I would point out that Jesus spent much of his life on earth teaching people who wouldn’t simply accept his words without question. I get the feeling he enjoyed the discussions.

The days of defending our faith to non-believers by saying ‘well, it’s true because the Bible says so,’ are long past. If they ever existed at all, that is. Those of us who believe might abide by that rule, but others aren’t so constrained. And they expect, and deserve, more from us than platitudes.

This makes us better, I think. It forces Christians to confront our own beliefs, facts, fallacies, biases, hopes, joys and failings. We don’t get a pass in popular culture, national media or academia. We have to understand history, archeology, language, ethics and all the rest in an endless attempt to try to demonstrate the truth and relevance of what we hold true to those who are unconvinced. And, by the nature of our faith, we are supposed to do it all in love. We are to love God, love man and love even those who press against us, challenging us at every turn. This is how we are to confirm, and spread, our beliefs. Not by theocratic fiat.

This is so true that I would offer a gentle warning to those in colleges, universities and even the media who try to shield their students or audiences from ideas that conflict with their own. These days the ‘trigger warnings’ on content in media, books or classroom dialogue, the banning of contentious speakers (usually from the political right) serve to offer a soft downy nest for minds young and old. But minds (like bodies) have never grown stronger by comfort, only by challenge. If you want people to have incisive minds, it is better for them to be questioned rather than coddled.

But now, perhaps, we Christians have an opportunity to simply take it easy. Because the rules for truth claims seem to have taken a downward turn. The evidence for this is Bruce, aka Caitlyn Jenner. You see, in our evolving culture, ‘facts’ are considered oppressive things. Feelings, however, are inviolable. So when former male Olympian Bruce Jenner feels like a woman, or ‘identifies’ as a woman, that’s all it takes. Suddenly, she/he is a icon of feminine glamor, splashed across magazine covers and welcomed to womanhood by no less than the President of the United States. And anyone who denies him/her is simply on ‘the wrong side of history,’ whatever that ridiculous phrase means.

The greater implications are that everyone must be accepted and embraced based on what they think, or feel, inside. As such, a suicidal person who says ‘I’m not good, I should die,’ must be speaking the truth. A racist of any stripe who sees herself or himself as fundamentally superior must have a unique inner perspective worthy of our respect. And by extension, the young woman with anorexia, who believes she is obese, cannot be denied. All truth emanates from one’s own mind.

By extension, then, who can tell me that God does not dwell in my heart? That my motivations for morality, however I live them out, are false? Who could now scoff when someone says, ‘God speaks to me every day?’ Or even, ‘catering that wedding will violate my inner conscience?’

In this evolving intellectual climate, no one can do so. My beliefs, our beliefs as Christians, suddenly take on a protected status, not subject to denial, whether they concern abortion, homosexuality or any other hot-button cultural issue. If that’s the ‘lay of the land,’ we would be mad not to use this to our advantage. It is, after all, a supporting premise of modernism. Perhaps we’ll end up in a cultural maelstrom in which feelings superseded all tradition, legislation or litigation, with a federal Dept. of Feelings to arbitrate it all.

However, I sure hope not. Because I’d prefer the give and take of genuine inquiry, the tough question, the freedom to argue and the liberty to boldly disagree, to the mental mush that would result from shielding and ensconcing the whims of every individual’s subjective perceptions.

At least, I feel like I would!