Wednesday, March 17, 2010

Callings

Callings

Breathless. Plunged in cold anticipation,
Thoughtless of the present passing.
Senseless of all nature’s motion, crying
Voiceless pleas for heartfelt contemplation,
Mindless of concern for wealth, sweet ease, or clout.
Sightless, swooning in the shadows –
Hopeless nearly, in this quiet.
Lifeless. Wakened: “Lazarus, come out!”


A brief explanation:

The poem is meant to invoke two perspectives with a similar thought pattern, which is communicated primarily through the first word of each line. These can be taken in any order. Initially, you can consider the poem through the perspective of the cadaver. It lays breathless, thoughtless, senseless, voiceless, etc. But the presence of death shouts to any and all observers to stop and reflect, prompting questions such as the following. What is important in life? What matters? What determines why I do what I do? What hope is there after death? When, through the seemingly all-encompassing power of death, everything seems hopeless and beyond even despair itself, a voice is heard. The words are taken from John 11:43, and show the power of Jesus Christ in raising the dead, bringing life to the lifeless. The anticipation in the first line is meant to give a hint that there is indeed some hope in the midst of a fallen, death-laden world. And this hope is found in Christ, as His resurrection becomes the basis of hope for the future resurrection to life of those who believe in Him.

The second perspective is that of my own, true to my experience, though not all in one unified moment. As I view the person before me for the first time, I am breathless, thoughtless of what’s going on around me. My focus is on the being before me who once was a person. As I fall into meditation, I become ignorant of the scene around me and desirous that others would join with me in considering those matters which are of first importance. Such was the impact of the moment on my psyche, that I really did have my vision go in and out, being sightless and swooning. In the face of the reality of death and the task before me of becoming a doctor, I often sense some degree of hopelessness. It’s in this lifelessness of my own and the lifelessness of the passed being before me that I am wakened from my slumber by the words of Christ, which remind me of a power that is in me that goes beyond me. He will help me. Through me, He will heal, physically and spiritually. He calls me to come to the task He has given me, and He gives me the power to do so.

The title revolves around the multiple callings in the poem. The cadaver calls. I call. Christ calls.

Monday, November 23, 2009

A Few Hours in the Life of an Internist

In my view, there are two meanings to the phrase “internal medicine.” The first is purely medical and denotes the common sense of the expression. Internal medicine consists of that specialty within the realm of physicians that is primarily concerned with diagnosing and treating diseases, typically by means of a non-surgical approach. There is nothing wrong with this meaning. It’s rather correct. Like a Sherlock Holmes of physical ailments, the physician stealthily stalks the cause of his patient’s symptoms. He uses his battery of skill and knowledge accompanied with a combination of the acute powers of deductive and inductive reasoning. Assisted by the prowess of his mastery of physical examination and the modern technology behind so many laboratory tests, the clinician shrewdly determines what is happening inside his patient. He sees what is internal.

But there is yet another meaning to the phrase, a nuance that reaches beyond the physical, plumbing the depths of far deeper and difficult illnesses than those assessed through physical diagnosis. While the internist deals with the varied bodily diseases of time and chance, he is often faced with foes of a more menacing mien, the maladies of a depressed spirit, a lonely soul, and a dissolute lifestyle. And these to only name a few! Most of what many doctors meet with in their daily practice is rooted in some problem that lies beyond the somatic sickness that the patient presents with. Thus, they deal with that which is internal – the soul and being of the patient.

As in the case of my recent preceptorship with an Internist, a woman may come for treatment regarding a lump that suddenly appeared on her abdomen, causing her pain and alarm. Now if the lump were present upon her examination in the clinic, the case would be simple. But just as quickly as it appears it also disappears. This is not the first time she has come to see her physician regarding this strange physical illness. She visited before, and the doctor had examined her, performed an MRI, and found nothing wrong. Thus, upon her return for the same complaint – the doctor knowing his patient quite well – he comprehended what she truly needed. And before he ever scrutinized her that day in the office, he wrote a prescription and delivered medication to her in the form of an unsuspecting first year medical student. Sent into the room upon the pretext of taking her history, halfway into our conversation I began to realize that the woman sitting across from me was depressed, lonely, and in need of a friend. I had taken her history. Nothing struck me as being in any way significantly physically wrong with her. And slowly, like fingers of light creeping over the morning sky, it began to dawn on me that I had been sent into the exam room not so much to find out what was wrong but to treat what was wrong; I was the treatment. I was a person to which this sorrowed and solitary soul could release some of her worries and cares, find a cheerful laugh, and meet with the bright eyes of youth. I was practicing internal medicine.

Such experiences are, I assume, a motif throughout medicine. For while we live, our physical being is integrally linked to our spiritual being, each affecting the other, much like a relationship between two individuals. Though I am one person, my one person is an intricately woven tapestry of many colors and threads. And the unraveling of one thread can transform the whole, either for better or for worse. Spiritual and physical intersect and traverse one another, crossing and braiding, looping and winding, now distinct only to be suddenly seemingly indivisible. As a tailor and mender, the physician must see the whole picture of his patient, snipping a thread here and reinforcing a seam there. He must be able to see both the physical and spiritual sufferings of his patient and to place the healing hand on both.

Monday, November 9, 2009

Here's the Person

---This is a continuation of a previous post entitled "Where's the Person?"---

Evolution abysmally flops in attempting to explain personhood. Darwin divests us of who we are, leaving us as nothing more than conglomerations of atoms and molecules, the complex piecing together of sugars, amino acids, and nucleotides. Through its concept of emergent properties, evolution fancies to explain who we are, but it's tale is as feasible as a just-so story. It's akin to the yarn that Aaron spun for Moses, "I threw the gold into the fire, and out came this calf. It just appeared! Amazing, isn't it?!"

But it is no use to show the insufficiency of evolutionary theory unless we can present an alternative that accurately describes the reality of who we are. Even if evolution tailspins when describing the personhood that is within each of us, what are we left with if there is not some other explanation that leads to the fulfillment of the longings within us. What of these longings though? Are they real? Am I simply writing from my own experience that which is not true of the whole of humanity?

Listen. Can you not hear the common theme rising and falling throughout the song of humanity? The long, low notes lift their sorrows in the somber tones of the old negro spirituals. They blow across the obliterated fields of the oppressed and war weary people, opening the refugee's mouth in hopeless cries of terror and despair. And still those notes move on through the throes of shattered history, played on the broken heart strings of the wounded spirit of every man and woman. This is the dirge of suffering, the mournful music of throbbing hearts as they yearn for something more - an end to the evil within us, around us. The doleful howl echoes through us all, our longing sigh for rest.

What says the student of Darwin? What consolation does he offer for the child afraid of the dark, the weeping widow, the man born blind, the unfortunate victim of malicious crime? None. What explanation can he afford to explain our rose? Where on the cold steel of the dissection table lies her personhood?

All our longings for rest and rescue, all our hungering for something more, all our pleadings for justice and mercy - the gospel answers these cries. Here they have deep meaning, significance rooted in the person of Jesus. No more are they the meaningless results of vacillating gene pools. They find a fountainhead in the stamp of God that lies on who we are as creatures made in the image of our Creator, meant to be in relationship with Him. We cannot divorce who we are as persons from who we are as creatures. Significance dies when God does. It lives afresh in Christ, gasping forth as the breath draws anew into his now glorified body. In Him, the rose of our humanity blossoms to fullness, and though it may wilt and wither into the grave, yet it will rise again. That same breath that rushed upon and into Him in the tomb will cross His gentle lips to breathe new life into all who are His.

"If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world." -C.S. Lewis

Tuesday, October 27, 2009

AMSA Presents on the LGBT Community

I'll get back to my previous post later. For now, I want to hash out some reactions to the presentation that the American Medical Student Association made today on the Lesbian, Gay, Bisexual, and Transgender Community.

Before proceeding, understand that love is to be our motivation in all things. If we lack love, we are a noisy gong or a clanging cymbal. My comments and replies here to what was said or observed are motivated out of love. For instance, I have told and will continue to tell someone who is a homosexual that they are wrong in what they are doing because I love them. It is not motivated by hate. So we must throw out the accusation of homophobia. I am not afraid of homosexuals or homosexuality. I am secure in the love and grace of God, and I pray that His love flows out through me even in this very post. If my rhetoric is sharp and my language appears piercing, then remember that the scalpel is also sharp, but it is for our good. And we would not accuse the scalpel of being the sword.

Do you choose to be sexually attracted to someone? Whether you answer yes or no is not the point. The question is a red herring. The desired response is "no." Why? Because we have this perception that if something is innate then it is also excusable. But is this correct? First, if someone hits you out of malice what is your initial response? Anger? Ok. Do you choose to have that anger? Initially, no. But can you facilitate that anger? Yes. Are you deemed responsible for your reaction, both that initial reaction and the follow-up? Yes. Does it follow then that a homosexual attraction is permissible simply because it is innate? Second, is an innate impulse self-justifying? The argument for homosexuality on this point is that since we cannot control who we are attracted to then it must be ok to be attracted to the same sex. It's natural. There is evidence, and we have discussed it in classes, that there exists a genetic component to alcoholism. Thus, there are those who are strongly predisposed to becoming alcoholics. Their first drink is like the clank of the cell door behind them. Forever they try to escape the constrictions of their addiction, but they are their own prison wardens, bringing themselves back time and time again. Do we excuse these substance-abusers because of their natural predispositions? Not at all. We - the medical community at large - still condemn their drunkenness, and advocate a meaningful choice towards a change in lifestyle. We ought to deal gently with them, but the "natural component" of their condition does not justify their actions. If we are to learn our morals from nature then women ought to murder their husbands and eat them; thus says the praying mantis.

Appropriately so, as a future physician I need to know how to make for an environment that allows for an LGBT individual to open up to me about their lifestyle. I need to know about their sexuality because it affects their health and health treatment. I want to be welcoming to them. But how? What does it mean to be welcoming? It does not equal approval. The supreme example of this is found in the parable of the prodigal son. The father welcomes his younger son home, but he does not give his approval to what he has done. His longing for his son's return is evident. He waits on the street. He looks down the dusty road. He gives his child his ring and his robe. But never does this loving father condone his son's journey into that far country of promiscuity and profligacy. My point is this: beware of spin doctoring. I can be a welcoming doctor towards the LGBT community. But I will not be an approving doctor towards them. To endorse their actions would be against the proper practice of medicine. To facilitate their actions would be against my conscience.

At this point, we do well to observe God's mercy and forbearance towards us all. I am no different than any other human being in nature. I am a sinner. I deserve death and hell. My sin is equally as bad as any homosexual act or desire. Yet God shows me mercy, and not just me; He shows mercy to all. He makes His sun to rise on the just and on the unjust. His Son died that all who believe in Him might live. Christ is the grounds for God's mercy towards me as well as my neighbors' mercies towards me. Likewise, He is the basis for me to show mercy to others, to love them even though they may defy God and wrong me.

My main points are as follows. First, the reasoning behind the approval of homosexuality makes for an inconsistent worldview. Second, we can welcome homosexuals while not approving of their homosexuality. Third, our motivation for telling a homosexual that what they are doing is wrong flows, or ought to flow, out of a wellspring of love towards them. Defining homosexuality as wrong is not indicative of homophobia. Fourth, we ought not to think of ourselves more highly than we ought to think. We all are undeserving recipients of mercy, especially those of us who believe.

God have mercy on us all.

Friday, October 23, 2009

Where's the Person?

Medical school has been underway now for well over 2 months. It's not an easy endeavor. Becoming a doctor is a lot like trying to become a scientist, spiritual mentor, trusted adviser, and universal problem-solver all at once. Any one of those, if you seek to do it well, would fill up to overflowing the capacity of one lifetime. And here I am in medical school trying to master them all at once and as quickly as possible.

Now this would be slightly more feasible if the teachers nurtured you only on that sweet milk of truth that is found in Christ. But when attending a secular institution, or even a Christian one for that matter, you cannot expect that the classroom will be sterilized of all falsehood before you arrive. Not at all. We live and move in a world of competing ideologies. And in the marketplace of ideas, a brutal capitalism reigns in the exchanges that take place, the market filled with cheap products, clever and constant advertising, and prices that demand your very soul. Everyone wants you and no one wants you. You are only opportunity for another advertisement, an potential proselyte for a secular intelligentsia to play out their academic hypotheses in the real world. But there is one stand though where you can come and buy without price; the price of a life has already been paid - freedom purchased.

In the arena of medical and science education we are told that we have migrated up through the ranks of atomic and molecular diversity to the tyrannical position of the human being. Being more suitable to our ever changing environs, we have managed to "outwit, outplay, outlast" the other chemical bags of competition. There are many weapons one could choose to assault this fundamental tenant of Neodarwinism (and yes, neodarwinists are fundamentalists). But is it not the rose, lightly tossed onto the pinnacle, that causes the whole heap to tumble?

Where is my rose you may ask? I can tell you exactly where it is: table 7 in the Gross Anatomy Lab on the campus of USC School of Medicine. I know that to you it may not sound like you would find a rose in such a place. And perhaps you're right. In fact, I concede. You are right. The rose is not there. That which once housed a rose lies on table 7.

You see, my cadaver lies on table 7. And in all of my dissecting (the cutting, the sawing, the pulling and digging), I have yet to find the person inside of my cadaver. Do you doubt that she is a person? So do I. But I do not doubt that she was a person. And if evolutionary biology buttresses its own dogma, then she is no less a person now than she was before she ended up on table 7. So where is the person inside the shell that lies on table 7? I could go through all that we have done to her, presenting to you each of her varied pieces and saying, "Nope, not here," but such a method is highly unnecessary.

Inside a human life resides a flower of beauty that eclipses the grace and splendor of any rose. Though this beauty may become very marred - indeed, very ugly - it is still present to some degree in the very presence of life itself. Life is beautiful. And the more I meditate on the kaleidoscope of living color that whirls and swirls around us every day, the more I am struck by how beauty defies materialistic reductionism.

For instance, why is my eye blue? I can hear the over-eager student of molecular biology now. "Your eye is blue because of a complex combination of genetic alleles that you received from you parents, which, upon their transcription and translation, produce specific proteins that give pigment to your eye so as to protect your retina from harmful rays of light. These alleles were produced over time through a series of genetic mutations in your ancestors, leading you to have the proteins that cause blue eye color." But that's not the question I asked. That explains how my eye is blue. It doesn't explain why. Why is my eye blue? If the matter is simply one of protection from rays that could damage my eyesight, then there are many colors that would do, and any one color would satisfy the requirement for the entire human race. Cue the classic answer of evolutionary biology: "Your blue eyes - as opposed to your eyes being brown, green, or any other color - enhance your possibility of attracting a good mate, which leads to the potential for offspring and the opportunity of your genes propagating through time." Now I understand! It all makes sense. Not really. I know that my wife does appreciate my eyes, but they had very little to do with our initial attraction to one another, and through the difficult times in our dating relationship I can hardly see her sitting at home saying, "But I must marry him! He has blue eyes! I couldn't marry a man if he didn't have blue eyes. I mean, it would be even better if he was named Earnest, but marry someone without blue eyes? I simply couldn't!"

My question remains unanswered. Why? Because in evolution everything has to have some pragmatic value. There is no place for simple beauty. Beauty is always seen as a means to some other end, almost always that of successful reproduction. But how does the beauty of a tree enhance its possibilities for reproduction? Bees talking amongst themselves: "Hey guys. Listen. I found this tree with some pretty hot flowers, some shimmery bark, and a nice color of leaf. How about we head over there, cross-pollinate it, and propagate its genome? You guys in? Good. Let's go!" In effect, beauty becomes the sex-slave of evolution, and so it is degraded.

Back to table 7. The corpse lying there is not what she once was. She lacks her former beauty, not only physically so but metaphysically so. There is a spiritual part that is the whole part of her, and it is missing. The beauty of life and personhood is gone from her. If it was still present, then to treat her the way we do would put us in the same room with Mao and Stalin. Evolution ignores personhood and beauty. In fact, it detests them, especially personhood. It comes up with empty words and concepts, such as "emergent properties," in order to force this rebel of personhood into the ranks of mindless natural selection. But the voice of truth is not so easily smothered.

Neodarwinism fails here. What then succeeds?

---to be continued---