Remember those who care for the wounded. Las Vegas and beyond…

My column in today’s Greenville News.  Remembering those who respond in times of crisis; Greenville, Las Vegas and beyond.

It’s hard to put into words the horror we all feel about the events in Las Vegas last week. So I won’t try. But what I will try to do is point out an often unspoken reality. Which is that those who work in emergency care constantly face terrible things with courage and skill and keep coming back for more. And everyone needs to remember that all those folks society counts on are truly remarkable.
Imagine, if you will, being the police officer who is called to an accident. They’re usually the first ones there. They roll up and survey the scene to make sure it’s safe. There’s twisted metal, spilled gasoline, possibly a fire. And all too often, there are gravely injured people covered in blood, surrounded by others screaming for help or trying their best to give aid. They call for EMT’s, paramedics and firefighters. They may start CPR. Or, if it’s the scene of a violent crime, they may be busy fighting to save their own lives, or the lives of others, from a violent death.
Next, those medics and firefighters arrive. Their job is to assess and stabilize the injured and get them to the hospital as fast as reasonably possible. They have to keep the scene safe, manage airways, put in IV lines, administer medications, dress bleeding wounds, shock dangerous heart rhythms, splint fractures and gather information. All in the chaos of passing cars, flashing lights, blistering heat, pouring rain, driving snow or dangerous winds. Never mind that they see heart-wrenching scenes of tragedy and loss; broken bodies of adults and children, grieving spouses, frantic parents. Never mind that sometimes they’re in as much danger as the patients when they treat the victims of violence.
Once they arrive at the hospital, it’s nurses and nursing assistants hurrying to move patients onto the ER bed from the EMS stretcher. Trying to get more information as patients scream, trying to replace IV’s that fell out, check falling blood pressures, slow rapid pulses, cover open wounds. Hanging blood to replace what has spilled on the floor; the tile slick underneath their shoes.
The nursing staff is busily notifying physicians of second to second changes as the gravely injured improve or deteriorate. Looking into the terrified eyes of patients who ask, ‘nurse, am I dying?’ and trying desperately to be hopeful. ‘Not if I have anything to do with it!’ It’s the nurses who are trying to restrain the frantic, confused patients. And sometimes, all too often, the nurses who are threatened, punched, kicked or stabbed by patients. It’s the nurses dealing with us irritable physicians and our demands. And escorting the families to the bedsides of those who died, or whose injuries and illnesses are unlikely to be survivable.
And there are the physicians, moving between rooms, assessing, deciding, placing lines, ordering X-rays and labs, putting tubes in collapsed lungs, evaluating who needs to go to the OR next; in large disasters, deciding who will have to be ignored, as they will not, cannot, survive. Physicians balancing the seriously sick and injured against the not sick at all who come with a rash, a fresh tick-bite, an ankle sprain; all ‘customers’ in the modern hospital paradigm. Customers who need to be seen as quickly as possible, and who are sometimes unsympathetic to the tragedies unfolding around the next hall.
It’s dramatic and it’s glorious in its own way. But all of those wonderful, dedicated people eventually struggle. The pain gets inside them, and even as they do their best, they wrestle with the memories, the question ‘did I do enough?’ And with the fear that it could happen to them or their loved ones. Some of them will face PTSD and depression. Too many of them will kill themselves because it was just too much. And a great many, especially in law enforcement, fire, EMS and nursing, are paid far less than they’re worth.
My heart goes out to all of those responders in Las Vegas. And Miami, Paris, New York, Kabul, Mosul, Houston, Puerto Rico, London. And in every place where brave folks bring hope and order against the background of blood and last breaths.
It’s remarkably hard to describe. And those who endure it all are either too humble, or to wounded, to tell the whole story. So have pity on them. And advocate for them. The world needs them 24/7.
God bless them and ease their pain as they ease the pain of others.

If God had an ER, I’d be a regular. (A devotional reading)

This was originally given to a group of Christian physicians and their spouses. But ultimately, I think it is relevant to everyone, physician or not.

If God had an ER, I’d be a regular!

They come from every walk of life, every age, race, nationality, financial status, sexuality and gender. All hours of the day, and of the night, they trickle or pour through the doors of the ER.

I have been doing it for 21 years. And I am, by now, seldom surprised. I am not stunned by intimate complaints, I am not shocked by bloody injuries, I am not amazed by ridiculous questions that suggest a complete lack of knowledge of their own bodies.

I am, however, petty. I am sinful and sometimes angry. I am snarky and sarcastic. ‘What did you think would happen?’ I ask. Or this one, at 3 am, who came by EMS for a wart: ‘So tell me, what’s YOUR emergency?’

I am tired; that’s the reason for some of it. And I am unable to change much. The fixed realities of modern medicine are largely unyielding to me, a small fish in a small pond.

But sometimes, I am prideful. ‘I would never do that!’

Sometimes I am greedy. ‘I’ll never make a dime for this.’

Sometimes I am uncaring. ‘She’s going to die; why can’t they accept that?’

And other times I am insensitive. ‘It’s just a fever, I don’t know why that mom is so worried!’

They are so needy! Oh my goodness, their need exhausts me. This is my confession, that I am overwhelmed.

This one needs pain medication and that one needs a work excuse.

He needs discharge papers and she needs a cup of ice.

She needs a referral but can’t afford it. He won’t take his medicine even though he can.

She thinks she might be pregnant but won’t get a test. He wants help for his drinking. But he’s drunk right now, so that doesn’t count.

They were in a minor car wreck and their lawyer said ‘go get checked.’

They were at work when someone vomited, now everyone is vomiting and thinks they have been poisoned.

This one was exposed to an STD. That one wants a Viagra refill.

He thinks his 15 years of back pain needs a specialist now. She thinks she saw a spider on her leg and thinks it might be fatal; she saw it on Discovery channel.

After a night like this recently, I came away with an insight.

‘Lord,’ I said, ‘you must love us a lot because we all act like my patients.’

So let’s pretend, for a little bit, that we are the patients. We are the annoyed, annoying, needy, sick, dying, worried patients.

Question 1: What’s the most ridiculous or annoying thing that anyone has ever brought to you as a physician? What complaints or issues simply make your hair stand on end; make you want to run out and get a welding certificate? What seemed so silly, so obviously unnecessary, that you almost said something you’d regret? (Shop vac and spider)

Now this Question: What’s the most ridiculous thing you’ve ever brought to the Father?

Pause to consider it.

Was it ridiculous to you?

Was it ridiculous….to Him?

Do you think for a second that he laughed, or turned you away?

The children were brought to him so He might put His hands on them and pray. But the disciples rebuked them. Then Jesus said, ‘Leave the children alone, and don’t try to keep hem from coming to me, because the kingdom of heaven is made up of people like this.’ After putting his hands on them, he went on from there. Matthew 19: 13-15

He knows your need. And he does not mind your asking. Even if it’s the ridiculous question of a child; or an adult. In fact, you are expected to ask, to come with your need.

‘For we do not have a high priest who is unable to sympathize with out weaknesses, but One who has been tested in every way as we are, yet without sin. Therefore, let us approach the throne of grace with boldness, so that we may receive mercy and find grace to help us at the proper time.’ Hebrews 4: 15-16.

Question 2: Has anyone asked you for something, as a patient, that you just didn’t have the energy or will to do? Have they had a complaint you didn’t want to pursue? Have they had a need for a prescription, form, anything that you just didn’t or wouldn’t do? I confess that sometimes I don’t want to write the work excuse. Or check that extra test they ask for; just because I feel I’m being pressured. (I’m not always nice…but then again, none of us are.)

What need have you brought to the Father? Think about it for a minute.


Did he turn you away? Oh, he may not have met it the way you wanted. But did he turn you away?

Whatever you ask in my name, I will do it so that the Father may be glorified in the son. If you ask ask Me anything in My name, I will do it. John 14: 13-14

Question 3

Do people come to you, as a physician, with questions for which the answer seems absolutely, obviously, painfully simple? Do you wonder why they don’t know the answer? Do you want to ask, ‘Are you kidding me? It’s just…a…fever!’ Does it ever seem like your job is simply reassurance? Do you forget, sometimes, that they didn’t go to medical school?

Do you ever come to the Father with questions that you should already know the answer to? With fears and doubts about His love for you? With uncertainty about your already certain destiny? With doubts that He knows what He’s doing? The same way people ask you, ‘are you sure I’m going to be alright?’ Or ‘how many times have you done this?’ Or, to me, ‘Are you going to have a practice someday?’ Or ‘I couldn’t get into the real doctor, so I came here.’

Pause for a bit to consider the questions you’ve brought to ‘God’s ER’ that you ought to know the answer to, as a believer.

Do you believe, for an instant, that he minds calming your fears; for the hundredth time? Jesus says:

I have written these things to you who believe in the name of the Son of God, so that you may know that you have eternal life. 1 John 5: 13

and Paul says this

Don’t worry about anything, but in everything, through prayer and petition with thanksgiving, let your requests be made known to God. And the peace of God, which surpasses every thought, will guard your hearts and minds in Christ Jesus. Philipians 4: 6-7

He does not condemn the worrier, but reassures the worrier. So much of the scripture is a reassurance in the midst of a worrisome, terrifying, fearful life. Just the way we find ourselves reassuring patients that things are alright. They don’t always know it and they need for us to tell them.

The Father tells us over and over. And like our patients, we keep coming back with the same fears.

It’s OK, he doesn’t ever say, ‘don’t ask me again.’

Question 4: Do people come to you with questions you have NO idea how to answer? With complaints that seem to be genuine concerns to them, but do not fit any recognizable pattern? ‘The pain goes from my left eye to my right knee, every night at 8 pm, and makes me have dizziness and itching for 30 minutes. What is it?’ Or do they say to you, in your exhaustion and at your wits’ end, ‘I’ve been to Mayo clinic and Cleveland Clinic and I’m here because I can’t stand this pain anymore. Can you help me?’

Snarky, sarcastic me, says: ‘I’m not smart enough to solve your problem this morning at 3 am.’

Consider this: Do you bring situations to God that simply haven’t been solved? Questions that haven’t been answered? Do you bring to him desperate conditions or hopeless scenarios? Do you doubt HIS professionalism? Do you wonder if he has an answer or a solution to your pain?

Pause to consider.

I’d say that there is always an answer. Sometimes, however, it’s not an easy answer. You may have to keep asking and looking and trying.

Suppose one of you has a friend and goes to him a midnight and says to him ‘Friend, lend me three loaves of bread because a friend of mine on a journey has come o me and I don’t have anything to offer him.’ Then he will answer from inside and say ‘don’t bother me!’ The door is already locked and my children and I have gone to bed. I can’t get up to give you anything.’ I tell you, even though he won’t get up and give him anything because he is his friend, yet because of his friend’s persistence, he will get up and give him as much as he needs. So I say to you, keep asking, and it will be given to you. Keep searching, and you will find. Keep knocking, and the door will be opened to you. For everyone who asks receives, and the one who searches finds, and to the one who knocks, the door will be opened. Luke 11: 5-10

The search, the asking, the seeking itself is working some change in your heart and soul. It is chipping away rough edges. It is heating the iron of your eternal self and shaping it into the perfect being that lies in your future as you become more and more like Him.

Question 5: Do people ever come to you simply because they have nowhere else to go? With questions that make no sense, with stories that are so wildly confabulated that there must be another problem? With bruises they won’t explain? Or with tearful eyes and clutched chest and you say, ‘have you been under any stress?’ And they suddenly sob? Do you ever think, ‘I really don’t have time for this today!’

Do you, yourself, come to the Father with nothing but your own brokenness? With no way to even ask the deep questions? With no knowledge of the answer you want? With a crushing sense that everything is spinning out of control?

Pause to consider a time when you did this.

Do you think that God was wearied by your desperation? Do you think that he puzzled over what you were saying? Do you think he was unmoved by your sorrow?

In the same way the Spirit also joints to help in our weakness, because we do not know what to pray for as we should, but the Spirit Himself intercedes for us with unspoken groanings. And He who searches the hearts knows the Spirit’s mind-set, because He intercedes for the saints according to the will of God. Romans 8: 26-27

And this, which always makes me think of the masses, the desperation, the confusion I see and you see; and that He sees, in you and me.

So as He stepped ashore, He saw a huge crowd and had compassion on them, because they were like sheep without a shepherd. Then he began to teach them many things. Mark 6:34

The thing is, we are all the same as the patients who vex us. We are all the crazy lady in the ER hallway, the needy person in the room with the call-light, the drunk angry at the world and straining against handcuffs, the one quietly mourning, the one anxious for no good reason, the suicidal, the hurting, the dying.

We’re all those patients. And that’s OK with Jesus. He never leaves the ER anyway, but just waits for us to come to him. And thus he says:

Come unto me, all of you who are weary and burdened, and I will give you rest. All of you, take up my yoke and learn from me, because I am gentle, and humble in heart, and you will find rest for yourselves. For my yoke is easy and my burden is light. Matthew 11: 28-30

Rest, and remember to show compassion. For you have received it. And remember that you are loved and adopted by the God of the universe.

And he’s even in charge of the ER.

Scanxiety and follow up on my wife

For all who have followed along, Jan is doing well.  For those who didn’t know, she had squamous cell carcinoma of the base of the oropharynx last year, and received radiation and chemotherapy. 

She’s doing well, eating, gaining weight, has a little saliva and pretty good sense of taste.  However, she has an insane husband/physician who hovers over her endlessly and always expects the worse.  That is, recurrence.

Tomorrow we go back to MUSC for a follow up PET scan.  I hate scans.  I have scanxiety!  I always expect the worst, despite the lack of clinical evidence to the contrary in the way she feels, acts, etc.

Cancer follow up is a terrifying thing.  Everyone who has been there understands.  I feel perhaps more terrified than when she was being treated. 

So for those of you so inclined, prayers would be much appreciate tomorrow and the next few days, so that we can have safe travel to the scan and a good report from it. 

It was a long year, and I pray God will be merciful to  us and keep us from having to go back into the abyss of treatment again.  The odds are good, but my innate physician fear is at an all time high.

I confess that this may not seem very faithful of me.  My dear friend, an atheist, even reminded me I needed to have faith.   But it’s always hard when it’s someone you love.  In particular, the woman I met at age 19, married at age 25 and by whom I have four beautiful children.

Please keep us in mind and pray for mercy!

God bless you all!


PS  encouraging stories still appreciated, by the way.

Beyond the Cure

This is my column in the latest SC Baptist Courier newspaper.  Link and text.

Have a great day!

Beyond the Cure

By Ed Leap

Published September 15, 2011

One of the things one learns as a physician is that disease, even when defeated, leaves damage. Surgeries to repair injuries result in scars, and sometimes permanent disabilities. Radiation leaves hoarseness, pain, and its own kind of scars both on the skin above and the organs below. Chemotherapy, which can save lives, also causes miserable nausea, hair loss and effects on the immunity of its recipient.

 Edwin Leap

Even when physicians succeed in eradicating a cancer, or rescuing a victim of trauma; even when they excise or drain an infection or repair a congenital defect, there is residual. The evidence of the struggle remains.

Sin is like that struggle with disease. Each and every human, throughout history, has been afflicted by sin. Every soul in the great span that stretches out and down time, backwards through the ages and forward into the present, has known sin�s predations. For we are all assaulted by sin, infected with sin, born with its marring mutation on the perfect plan of the Creator. Its effect is pervasive. Sin causes the decay of our bodies, the dissolution and confusion of our minds, and the frustration and misery of our souls. Of course, sin is not a disease, for we are complicit in it, so it is a limited metaphor but a relevant one.

In much the same way, when we are changed by God�s grace, when we are saved, our healing occurs. When we accept Christ, the disease of sin is finished, the therapy successful. It is well represented in our baptism by immersion, our rising from death to life.

However, as with physical disease, the healing leaves marks. Even when it is expunged from us, scars remain. Even after it is removed, nailed to the cross and taken to the tomb in time and outside of time, the effects and marks of our sin may remain. A dangerous tumor is not removed without an incision An abscess is not drained without a puncture. And so, our salvation, our transformation, is not without effect, just as our sin was not.

As we move forward in faith, we are often tempted to believe that we were not made whole. When we see how easily we are tempted, when we contemplate the consequences that remain of our sinful actions (like depressions in the skin where tumors once were), we can easily hear our enemy say, like the charlatan he is, �You are not healed; you are still sick. You are not good, you are still wicked. God has no place for one like you! Unclean!�

But he is a liar, a false diagnostician, who would have us share his eternal doom � or at least wallow in his eternal hopelessness. He is beyond the cure. But our therapy came from the Great Physician, fully prepared to heal us, whereas the devil is unlicensed to practice.

Equally unprepared are we. When we assess ourselves as unlovable, unsavable, unhealed because scars and tendencies, patterns and �symptoms� remain, we must step back and look at the statistics on our cure. The salvation rate is 100 percent for those who submit themselves to redemption. (We physicians should do so well!)

Of course, it isn�t only the devil who speaks words of sickness. Sometimes we do it to one another. We judge harshly, and we fail to see the progress, however incremental, of those who were most horribly engaged with the misery of sin. They are not whole, but they are healing. They are no longer sinners, though they may sin. Their scars are fresh, their infection newly removed.

Focusing on scars may occupy us, and worry and fear may plague us, but they are worthless occupations that distract us from the wonder, the miracle of our transformation, our journey from death to life. Just as a mother whose child was snatched from death will see the child, not the wound, we must look at ourselves, and others, with thanksgiving and with blindness to those things which would cause us to doubt what transpired. For we are whole, even as we grow more in the knowledge and likeness of the one who rescued us from death.

One day our wounds will be gone. One day, the only wounds, the only scars we will ever see will be His. What a day that will be! Until then, rest assured that the marks are marks of healing, and the pains and struggles that remain do not negate our cure.

(My wife, for whom many of you prayed in the past winter, is healing wonderfully. Thank you for your intercession.)

Driving my wife to distraction

‘Are you feeling OK?’  That’s the question I ask my poor wife.  Day after day, sometimes hour after hour.

She is almost six months from her radiation and chemotherapy for oropharyngeal cancer, and from the pulmonary embolus that followed treatment.

The good news is that she is thriving.  Riding bikes, lifting weights, eating almost everything she wants and down to her college weight.  She is still a little hoarse, and sometimes still has discomfort with swallowing.  But otherwise, fantastic.

The bad news is that her husband (that’s me) is largely, how shall I put it, crazy.  Yep, that’s me.  I’m crazy with anxiety.  Crazy with memories of those dark days.  And even though I know, day to day, how well she is, I do what every good emergency physician invariably does;  imagine the worst possible complication or outcome.

As a physician, that skill helps me not to miss heart attacks, meningitis, strokes, ruptured spleens and dozens of other eventualities. As a husband, it makes me really, really annoying.

And as a Christian, it sometimes makes me seem quite faithless.  The scriptures are clear.  ‘Do not worry about anything,’ it says in  St. Paul’s letter to the Philippians.   Everyone, from God the Father to God the  son to angels, patriarchs and apostles says, repeatedly, ‘Fear not!’  In fact, it’s the most repeated command in the Bible.

However, I wallow in fear.  I don’t care for alcohol, I adore my wife, I have never used illegal drugs, (yes, yes, I eat too much), I try to speak the truth and not covet (though I really wish I could kill a deer now and then!).  So my true, pet sin is anxiety.

I suppose there may be some PTSD involved here.  When we come close to losing a spouse, it’s easy for the images, the memories to haunt us.  In addition, my work brings me in close proximity to many types of loss on a regular basis.  Maybe this is a recurring theme in health care providers or the families of those who survive terrible illnesses.  I don’t know.

All I know is that driving my poor wife nuts with my constant queries, my hovering, my stares (however well-intentioned) and my never-ending medical assessment of her every physical characteristic.

I suppose I just want to say, to anyone in a similar situation, it’s hard not to do it.  Especially for those of us in medicine, worry is kind of our job.  But when we take it home, it’s not very functional.  And it can easily drive our loved ones crazy, even as it drives us crazy inside.

And to those of us who profess Christianity, well worry is a tough affliction to overcome.  The world is full of hurt.  The world is a place of loss.  Life hurts. But we are promised that one day, all will be well. And that along the way, in every storm, we will have a guide.  Psalm 91, among many others, is clear.  The resolution of our worries, rational and irrational, may await eternity, but it will come.

The great challenge, in the interim, is simply learning to live day to day without a constant fear of catastrophe.  And with a daily resolution to enjoy every moment, without the poison of anxiety; real or imagined.

Please continue to keep us in your prayers as time heals the wounds, physical and emotional.  And let me know if I can return the favor.

God bless you,


Every second is a gift

Every second is a gift, no matter what the season

This is my column in today’s Greenville News

I am sitting here, looking into the sky and out into the yard. The clouds are hanging low over Tamassee. They are pregnant, but not so much with rain as with change. I can see, in their fullness and varied shades of blue and gray, that Autumn is lurking, and waiting eagerly to descend. Most years, there is a weekend in September that blows in cool, with low humidity and breezes. I mark the end of summer by that event, and often in years past would note it as I drove home from my night-shift in the emergency room. The air through my car windows had a chill, and as I slept off the night’s work, I would revel in warmth, not cool.

This time, while not as cool, it came in August. Frankly, anything less than a heat index of 104 is a delight, but the 80s seem like the 60s when the 100s are the norm. Or something like that. So, looking outside, I see, smell and feel change arriving.

In the bushes the remains of blackberries are shriveled; dried snack food for creatures preparing for the coming cold. We had lots of wild berries this year, but it just seemed to miserable to pick them. Always a pity to see them unused, even if picking them requires a tetanus shot and snake-chaps!

But I also hear the changes of fall. The sound of the insects is one of ending, almost of fatigue, a droning, langorous requiem. Many will die before long though their rich life-spans were marked in weeks, not decades. Their progeny will visit us in the Spring, doubtless believing with rapture that they are the first of their kind in Eden..

I hear something else. I hear silence. Although we home-school, my wife and children are off at a co-op class. The only sounds in the house are the heavy breathing of an aged cat, and the thumping and snarling of two kittens. And of course, my fingers on the keyboard.

My children are doubtless talking in the car, at least two of them asking question after question of their patient mother, who educates them with the passion a bear might defend her cubs. Their minds and characters her provence, having by now saved them from most of the normal physical self-destruction of early childhood.

While I love this new Autumnal silence that lets me write, I crave distraction in the form of the touch, hugs, laughter, requests and ideas of my kids. The noise is soothing as chamber music to me. Parenting, when one loves deeply, teaches the parent to love all of the frantic acitivty and madness of parenting. The quiet reminds me that I am addicted to my children.

And of course, to my lovely, thriving wife Jan. She distracts me as well, but in a more ordered and gentle way. I want to talk with her, to laugh with her and to work with her in ordering our daily lives. She is a master at that. Where I am chaos, she is a plan. Where I am idea, she is implementation.

Today Autumn reminds me that though Summer is waning, hope is alive even in the darkening skies and turning trees. But for more reasons than nature. Jan is on the other side of radiation and chemotherapy for the cancer that threatened her, and by default threatened all of us, last winter. In fact, it probably began (unbeknownst to us) last Autumn. She also is past the pulmonary embolus that followed all of it one March morning, and left the physician in me completely terrified.

We are enjoying the end of summer and ready for fall because, despite summer’s heat, bugs and endless activity, the preceeding winter was so cold. It chilled our bodies with weather and our hearts with disease and trouble. The passage of time is therefore a beautiful counterpoint to the way time stood still so often, in surgery suites, waiting rooms and even our own home as our treasured wife and mother lay ill.

In fact, the low clouds, the changes, even the start of school remind us, with thanksgiving to God above, that as in Psalm 30:5, ‘weeping may last through the night, but joy comes with the morning.’ A year has passed, and all is well. The earth turns and tilts from the Sun. But we are all still here, together. Every second a gift, whatever the season.

Thank you for your fervent prayers.

Mourning on the road home

We are called by Christ, among other things, to mourn with those who mourn, to weep with those who weep.

This sometimes happens, suddenly and briefly, in the emergency room.  I was sitting at my desk one quiet morning recently.  EMS traffic caught my ear and I learned that there had been a terrible accident not far from the hospital.  However, far enough that the regional helicopter had been called to the scene.

One patient would fly out.  One patient, one poor girl, one daughter, would not fly out.  And she would not come to me for care.  She died on the road at about 7:15 am.  She died on the road I sometimes drive to work, about 20 minutes after I would have passed the exact place she passed from this life.

I was stricken, I was saddened.  Father of four, I was nauseated and heart-broken.

That evening, after work, I drove down the same road.  There was no sign of twisted metal, no sign of spilled gasoline or burnt rubber.  There was an empty road, in counterpoint to the hearts of her loved-ones, now full of pain, full of sorrow, pierced by loss.

I don’t know them.  But I mourn, in a small way, with them.  And especially as I drive down that bit of highway on my way home, knowing she will not go home the same way ever again…at least not in this life.

It makes me long for the day when our Lord will wipe away every tear from our eyes.  The day when death will not stalk fresh victims.

And no road in all that kingdom will hold any memory of sorrow, or leave anyone mourning.

Devotions for Doctors…and patients! Facing illness as family, and with faith.

Trained as an emergency physician, my entire career has been spent pondering, searching for, often finding and managing the worst possible eventualities in my patients.  Chest pain is, first and foremost, a heart attack or pulmonary embolus.  Abdominal pain is appendicitis, a ruptured tubal pregnancy.  Fever with headache is meningitis.  And neck pain from a car wreck is an unstable cervical spine fracture.

So it has taken enormous effort to ‘dial-down’ my response to my wife’s recent cancer, treatment and recovery.  I drive her to distraction with ‘how are you feeling?’  I pester her endlessly to eat.  I have imagined every bump or cough a metastasis.  I have envisioned all the worst outcomes imaginable.  I endlessly ‘catastrophize,’ as one pastor put it.  And yet, God has seen us through so much.  She is thriving, six months from her diagnosis and three months from her last chemotherapy and radiation treatment; almost three months from her life-threatening pulmonary embolus.

We have been through follow-up exams, and scans.  Tense phone calls from tumor boards, anxious moments waiting for radiologists to make pronouncements.   And now, one more thing remains.  Tomorrow she has a little surgery to repair her scar.  And she has a little scope and biopsy to follow up on her slightly abnormal PET scan.  Despite the way my anxiety can run wild, despite the way that Satan gnaws at me with the barbed sword of fear, I know two things.  Rationally, I know that it is likely she will have no problem, and no residual malignancy.  She was treated as aggressively as one could imagine.

But I also know this, I have to know this:  she is in God’s hands.  This is no easy thing.  I am a kind of  ‘medical doubting Thomas.’  ‘Unless I put my hands on the report, unless I see the scan myself, I will not believe in God’s provision.’  But I have to move beyond that.

I have learned, thanks to this trial, my wife’s wisdom and the Word, that when God says He will rescue us from every trial, that He will ‘keep us from dashing our foot against a stone,’ when He says, ‘The angel of the Lord encamps around those who fear Him, and delivers them from all their troubles,’  He means it from a larger perspective than we can comprehend.  When He says He ‘forgives all our sins and heals all our diseases,’ it is true.  But the meaning is beyond the temporal.

If not, then every believer whose loved one dies of cancer can only rage against a lying, faithless Father.  And each of us, who will universally face the 100% morality of this life, will have cause to be angry with our Creator.

Some will be healed of their diseases, and we can pray for that, and we should pray for that.  I do it every, single, solitary day.  ‘God, Father, please heal my wife.’  So far, He has been faithful to that plea.

However, some will not.  And I do not claim to understand why, nor do I hope to judge God with what Pastor Mark Driscoll calls, ‘three pounds of fallen brain.’  But either way, all of us will find our  ultimate healing in the next life.  So when we trust God, as I am learning, we have to fall back into His arms, trusting that either way, now or later, with immediate joy or joy postponed, we will find the healing we so desire for those we love…and for ourselves.

I was told by a wise man that we were facing this trial because ‘you can be trusted with it.’  I am only now beginning to understand.  And despite my deep-seated, doctor-educated terror, I am seeing that God’s provision dwells mightily in some of the worse circumstances, and that if we would be a ‘light in the darkness,’ we have to be in the darkness.

God deliver us into new light, each and every one!

Please say a prayer for Jan’s surgery tomorrow.



So, how is Jan doing you ask?

Thank you all for your prayers for my dear wife.  I haven’t update lately, so here’s the latest.

We went to MUSC in Charleston a couple of weeks ago for follow up, some 12 weeks after completion of chemotherapy and radiation.  Jan’s exam looked very good.  Nothing going on in her tongue or throat except some generalized edema.  Healthy looking cells, unlike the scary white ones we saw back in December.

‘Hallelujah, thine the Glory,’ as the song goes!

She also had a PET scan.  It took a couple of weeks for the final reading and review by the tumor board at MUSC.  But the results were pretty good.  The left side of her neck was clear (that’s where the original malignant nodes were found).  The right side of her neck was clear except for one lymph node which was unchanged, and which did not ‘light up’ as if it were malignant.

On the base of her tongue there was some PET scan activity,  but there are a few options.  The tumor board felt that she should have another thorough scope under anesthesia to see if any areas needed to be biopsied.  However, they also felt it could have been a scratch or other area of non-malignant inflammation.  She has been eating pretty aggressively, so that’s a thought.  Likewise, she had a very pronounced inflammatory response to her radiation, so in my simple opinion, it may still be ‘cooling off.’

On the positive side, there were no distant areas of concern; that is, lung, liver, etc. all looked good.  And, she’s swallowing better and feeling better every day.  No obvious masses in her throat or on her tongue.

So, as with all cancer follow-up, it’s one more ‘wait and see.’  Wait on the scan, wait on the exam, wait on the biopsy, wait, wait, worry, worry, pray, pray, pray!

It’s hard to imagine that much is going on considering how active she has been and how healthy she feels.  But we must be cautious.

Also, if all goes well she can cut back her blood-thinner (Lovenox) at the end of this month and take it only once daily.  That will be fantastic!

As I write, she’s in West Virginia visiting family.  Before she left she had an excellent work-out in the gym.  Last week she taught VBS.  And every day she says to me, ‘don’t worry, I feel fine!’

Worry is my cardinal sin.  I’m learning, by increments, to battle it.  Just last night I was talking to a patient about not letting bad thoughts control her with anxiety.  (I feel qualified to address that topic!)  And today, the verse that came to mind was this:

I thank my God every time I remember you. In all my prayers for all of you, I always pray with joy because of your partnership in the gospel from the first day until now, being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.  Philippians 1: 3-6

Of course, Paul isn’t specifically referring to physical healing, but I believe that God began a work of healing in Jan and will see it through.

So we’ll keep everyone posted!  Please continue in your prayers for my darling.  And for me, so that I will be lifted up in hope, not weighted down with anxiety.

God bless you all for your love and intercession!