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.


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