Thanks for the interesting comments about my last post. I appreciate everyone’s input. Granted, it’s a tough topic and worth lots of discussion. We all have something to learn from one another.
For instance, from some comments I have learned that I am a self-centered, rich, naive, uninformed jerk who should simply stop demonizing and start loving.
Except that I’m not. I have been practicing medicine, in an emergency department, for 15 years. It’s hard to remain naive, sheltered or simple minded when you see everyone for everything. I know drug addicts and alcoholics, abused women and children, confused immigrants who speak only Spanish and frightened exchange students. I have shaken hands with more than my share of felons, and considered them pretty nice folks on the whole. I try to see them all, to the extent that I am so far able, through the eyes of Christ.
I understand a great deal about the poor. I am happy to see them. I have written off their bills and seen them under EMTALA for free. Our group seldom pursues collections on anyone.
But let me ask some questions. Those of you who think I’m demonizing the poor, those of you who think I need to shut up, sit down and do more, do you work in a setting like mine? Some of you probably do, but many do not. Have you struggled to find a disposition for a sick person, with no money, so that they can get the therapy, drug, equipment or surgery they need? Did you do it at midnight or later, after your shift was over?
Have you pleaded with a drug addict or alcoholic to go into treatment? Have you listened patiently to the rambling of a destitute schizophrenic, then struggled to find hospitalization for him or her? Have you tried to explain to poor teenagers why it might be best not to have sex, so that they can avoid having a baby at 14? Have you cared for the rape victim, the assault victim, the disabled, the violent or the demented, as their families held back tears?
Now, if you have, in some capacity, have you done it for no money? Have you gone back over and over knowing it will be for no compensation? Have you paid to do it, as we do when we pay malpractice and license fees? Have you known, even as you donated your time in the third world, that any one of the persons you helped might just turn around and sue you for millions of dollars for an honest mistake?
Have you, in your care for the poor, ever been frustrated by those who simply refuse to stay in school, hold a job, stop using drugs or stop sleeping with everyone they meet, and thereby father (and mothering) children who aren’t the least bit interesting to them? Have you watched those poor, who work as carpenters or mechanics, or who drink and fight all weekend, still manage to collect disability for nerves, back-pain or some other difficult to verify problem? Have you gone in to see them and been cursed, or had them say ‘well, it’s about damn time!’
Have you, as you point your finger at me or any other Christian social conservative, ever really looked at what Jesus said? Yes, he called us to care for the poor. And he called us to seek the truth. He called us to humble ourselves before God. He called us to work with our talents. He called us to sexual morality. He called us to repentance. He wasn’t just the guy who came and said, ‘be nice to the poor.’ He said ‘be holy.’ He said ‘follow me.’ He said ‘Go into all the world and make disciples of every people.’ He said he was coming back, and that when he does, he’s going to be very annoyed. He said some people would be cast into the fiery pit. He said ‘I am the way, the truth and the light. No man comes to the Father except by me.’
I looked at the board last night at work; the light board that says what patients we have and where they are. I saw their names all over that board and told a student who was shadowing me: ‘See those names? God loves every single one of them just the same as he loves me, or you. And vice-versa.’ I believe that 100% But I don’t believe that either poverty or riches excuse us from right behavior or effort.
A generation of young people )and many of their parents or grandparents) that come through our emergency departments have no sense of responsibility, no work ethic, no desire for advancement, no gratitude for what we give them and no respect for one another…they’re too busy partying and ‘hooking up.’
Jesus loves us all, but he calls us to the truth. He calls us to hard truths at times. And any Christian physician faces a duality. We are called to love, but not coddle. We are called to accept but not enable. We are called to tolerate, but not agree with all the beliefs, ethics or actions of our patients.
Fine. Cell-phones are cheap. Maybe I was dead wrong on that one. Granted, there are desperate poor folks in America. But I have a very hard time with many of those who, in the midst of their morbid obesity and lack of motivation, hide beneath the ‘nobility’ of poverty and use it as an excuse for others to engage in effort for them.
Tell me more, though, about alcohol and tobacco, the absence of motivation, the absence of fathers, teen-pregnancy, sexually transmitted diseases and serial sex partners, disdain of faith and morality and the disdain of learning. Tell me how cheap those are. Tell me how everyone has a right to those things. If you contemplate them, and roll around in them the way we do, you’ll get a slight idea of what we face, day and night, in the emergency departments of this country.
And until you have, indeed, considered all sides of the debate; until you have, actually, struggled with all your effort to help the poor in person, and done it for no pay; until you have held the hand of the HIV patient and tried to comfort the poor, abused child, then don’t judge me as naive, or stupid, or inexperienced.
Frankly, it’s a little insulting. My career has made me one of the least naive people on earth.
And until you read and accept all that Jesus said, don’t just snip out the convenient bits about the poor.
I was just catching up on your last two post and their comments. I also lived in a third world country (Cambodia) for two years. Also I’m an ER nurse for the past three years. Jesus did sit with the sinners and commune with the poor, but He also said to the adulterous woman to “go thy way, and sin no more.” Lydia, indeed Jesus didn’t criticize people for things they’ve done, but he didn’t pretend they were OK just because of their background. In Cambodia I saw the poorest of the poor, who despite their poverty, still chose to… Read more »
RunnerDoc
16 years ago
Thank you Dr. Leap for so eloquently verbalizing my thoughts and opinions. We need more of this honesty. Just because we as doctors tell our patients that smoking is bad for their health does not mean we “demonize” smokers. Or when we tell patients they should take their blood pressure medications even when they can’t “feel” their hypertension we aren’t judging them but providing good medical care. So what I ask, what is wrong with asking these same individuals to take Personal Responsibility for their lives and their healthcare. Spend less on wants and more on needs. To Lydia, I… Read more »
Lydia
16 years ago
I am sorry that you took my comment as an attack on you personally. I am not judging you, nor do I think you are naive, nor do I think you are not sincere in your caring for every kind of people or as a Christian loving them, nor do I think you are demonizing the poor. My response is written for whoever reads it – not just you. I am a nurse in an ER in downtown Detroit. I also volunteer time in a clinic for the uninsured. I am finishing my studies to be a nurse practitioner and… Read more »
Lydia
16 years ago
I did not use “demonize the poor” in my response. Someone else coined these words. There is no way that I feel anyone is doing this. And I am sorry if anyone interpreted my response this way.
RunnerDoc
16 years ago
To Lydia, Sorry I combined my response above to previous responses, (this blog entry and previous entry), and have inadvertently made it appear that the “demonize the poor” response was yours. I apologize for that and from reading your statements it is obvious that you are not of this belief and in fact quite the opposite. Suffice it to say that I agree with what the good Dr. Leap has written. Thanks for all that you do in service to others and good luck in your endeavors. Ok, back to working now and I’ll leave the writing to Leap who… Read more »
Lydia, Please don’t think I was especially replying to you. I was really just trying to establish my credibility, and it would seem the credibility of all of us ‘in the trenches,’ to speak about this issue. There are folks who might right my blog and think, from their theoretical ideological position, that I’m cruel and don’t know what I’m speaking about. I wanted to make the point that I do know. Clearly, so do you. We’re on the same page. And it is a constant battle. The dynamic tension between loving our patients and wanting to strangle them; between… Read more »
Edwin, I see my words stung a bit. That was not my intent. I was raised Catholic, and attended 12 years of catholic schools. While your faith differs slightly from that in which I was raised, it’s not too different. Some say Christ loves us all. I don’t disagree with that assertion. But one of the core values I learned from my religion was this: pity. Not pity in the sense that I may look down on the poor. Not pity in the sense that I think they are lesser than I. Not pity in the sense that they are… Read more »
I was in no way trying to negate your insights or your frustrations at the abuses you see. You have very valid points and I admire your compassion for those you serve. But being among the working poor, it is at times embarrasing that people perceive what we find as necessities as a way to condemn us. While cell phones can certainly be cheaper than home phones, there is a proper time, place and way to use them. While someone is seeking your advice, they should not be using their cell phone. Poverty does not excuse bad manners. Poverty also… Read more »
mamadoc
16 years ago
Gee, I don’t think anybody who’s spent much time working in the ER can be naive.
I hope not though. I’ve found out that single mother welfare is not really worth it. Let us use students loans for an example. I really need students loans and you also have single mother loans.
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I was just catching up on your last two post and their comments. I also lived in a third world country (Cambodia) for two years. Also I’m an ER nurse for the past three years. Jesus did sit with the sinners and commune with the poor, but He also said to the adulterous woman to “go thy way, and sin no more.” Lydia, indeed Jesus didn’t criticize people for things they’ve done, but he didn’t pretend they were OK just because of their background. In Cambodia I saw the poorest of the poor, who despite their poverty, still chose to… Read more »
Thank you Dr. Leap for so eloquently verbalizing my thoughts and opinions. We need more of this honesty. Just because we as doctors tell our patients that smoking is bad for their health does not mean we “demonize” smokers. Or when we tell patients they should take their blood pressure medications even when they can’t “feel” their hypertension we aren’t judging them but providing good medical care. So what I ask, what is wrong with asking these same individuals to take Personal Responsibility for their lives and their healthcare. Spend less on wants and more on needs. To Lydia, I… Read more »
I am sorry that you took my comment as an attack on you personally. I am not judging you, nor do I think you are naive, nor do I think you are not sincere in your caring for every kind of people or as a Christian loving them, nor do I think you are demonizing the poor. My response is written for whoever reads it – not just you. I am a nurse in an ER in downtown Detroit. I also volunteer time in a clinic for the uninsured. I am finishing my studies to be a nurse practitioner and… Read more »
I did not use “demonize the poor” in my response. Someone else coined these words. There is no way that I feel anyone is doing this. And I am sorry if anyone interpreted my response this way.
To Lydia, Sorry I combined my response above to previous responses, (this blog entry and previous entry), and have inadvertently made it appear that the “demonize the poor” response was yours. I apologize for that and from reading your statements it is obvious that you are not of this belief and in fact quite the opposite. Suffice it to say that I agree with what the good Dr. Leap has written. Thanks for all that you do in service to others and good luck in your endeavors. Ok, back to working now and I’ll leave the writing to Leap who… Read more »
Lydia, Please don’t think I was especially replying to you. I was really just trying to establish my credibility, and it would seem the credibility of all of us ‘in the trenches,’ to speak about this issue. There are folks who might right my blog and think, from their theoretical ideological position, that I’m cruel and don’t know what I’m speaking about. I wanted to make the point that I do know. Clearly, so do you. We’re on the same page. And it is a constant battle. The dynamic tension between loving our patients and wanting to strangle them; between… Read more »
Edwin, I see my words stung a bit. That was not my intent. I was raised Catholic, and attended 12 years of catholic schools. While your faith differs slightly from that in which I was raised, it’s not too different. Some say Christ loves us all. I don’t disagree with that assertion. But one of the core values I learned from my religion was this: pity. Not pity in the sense that I may look down on the poor. Not pity in the sense that I think they are lesser than I. Not pity in the sense that they are… Read more »
I was in no way trying to negate your insights or your frustrations at the abuses you see. You have very valid points and I admire your compassion for those you serve. But being among the working poor, it is at times embarrasing that people perceive what we find as necessities as a way to condemn us. While cell phones can certainly be cheaper than home phones, there is a proper time, place and way to use them. While someone is seeking your advice, they should not be using their cell phone. Poverty does not excuse bad manners. Poverty also… Read more »
Gee, I don’t think anybody who’s spent much time working in the ER can be naive.
I hope not though. I’ve found out that single mother welfare is not really worth it. Let us use students loans for an example. I really need students loans and you also have single mother loans.