Archives For Medicine

Dishonest Diagnoses

March 15, 2018 — 3 Comments

x-ray.png

Do you prefer honesty—or would you rather hear something that makes you feel good?

It’s pleasant to hear things that feel positive, but that feeling is fleeting, and potentially devastating, when we have heard a lie.

In a recent column devoted to a comedian who passed away two decades ago, I encountered a joke that probes this problem. Henny Youngman poses a dilemma, and solves it with the worldly solution. In the following one-line joke, he proposes an alternative to unwelcome news.

When I told my doctor I couldn’t afford an operation, he offered to touch up my X-rays.

If only it were so simple to change bad news to good. The truth may not always be welcome, but it is nearly always preferable to believing a lie. Sadly, avoiding discomfort by telling people what they want to hear, has become a modern plague.

Well, “modern” isn’t the best word. This dishonesty has been around for a long time, and it will persist until the Parousia. The Apostle Paul described it to a younger pastor by saying, “having itching ears [people] will accumulate for themselves teachers to suit their own passions, and will turn away from listening to the truth . . .” (2 Timothy 4:3-4)

That’s one reason that certain religious messages are more popular than others. They “promise” you that if you follow their teachings, there are only good times ahead.

An Honest Diagnosis

In contrast to these lies, the truth admits life is not always perfect. The truth acknowledges that doing right is often more difficult than going with the flow.

But trading the truth for the lie is dangerous. One can be approaching a sheer precipice, requiring swift avoidance. But if we heed the voices saying “all is well,” we may blindly step into oblivion.

C.S. Lewis described the way that Satan would like to have us deluded about our real condition and circumstances. In the Screwtape Letters, a senior demon offers evil counsel to a junior devil assigned as a tempter.

How much better for us if all humans died in costly nursing homes amid doctors who lie, nurses who lie, friends who lie, as we have trained them, promising life to the dying, encouraging the belief that sickness excuses every indulgence, and even, if our workers know their job, withholding all suggestion of a priest lest it should betray to the sick man his true condition.

If you are one of the minority who welcome the truth, however challenging, I commend you.

If you find yourself preferring those who encourage you to be comfortable and complacent about who you are and how things presently are, I encourage you to listen to other (more honest) voices. Voices that encourage you to become a better woman or man today than you were yesterday. Voices that call you to the true path God is laying out before you.

In the long run, altered x-rays will never help us to recover from the illnesses of body, mind and soul that assail us. Only the Truth is able to set us free.

Misplaced Trust

October 16, 2014 — 8 Comments

trustingWhy do some nurses kill? Most people attracted to the nursing profession possess deep reservoirs of compassion for others. And yet, every once in a while we read about a nurse intentionally taking the life of a patient.

Today’s case comes from Italy, where a forty-two year old nurse is under investigation for thirty-eight possible cases of murder. And we are not talking about the ending of a life that some would term euthanasia.

Poggiali did not overdose them to end their suffering. She did it simply because they irritated her. She, or their relatives, bothered her.

One troubling aspect of the case could only happen today. Authorities have actually found a photograph on her phone where she is standing beside a deceased patient giving a “thumbs up” sign. (The article didn’t indicate whether this was a sickening “selfie,” or if there is another person at the hospital with a similarly demented sense of humor.

When people we implicitly trust violate our faith in them, it is jarring. We struggle to comprehend things when . . .

Medical professionals intentionally cause injury . . .

Clergy behave immorally, particularly when they attempt to justify it from the pulpit . . .

Police victimize rather than protect . . .

Teachers care more about themselves than their students . . .

Soldiers display cowardice rather than courage . . .

There is some good news here. It is precisely because these breaches of our expectations are the rare exception, that we are shocked by them. For the most part, people entrusted by the public with authority or power honor that trust.

(Let’s exclude, for our discussion here, the case of politicians, where that supposition would be hotly debated. As Lewis in his essay “Equality” wrote, “Mankind is so fallen that no man can be trusted with unchecked power over his fellows.”)

Our trust in people who occupy special positions goes so far as to be illogical. For example, we tend to think of actors or actresses as possessing the traits of various characters they have portrayed.

We laugh at the joke, “I’m not a doctor, but I play one on TV.” Yet, we’re still tempted to ask the person how we can best deal with our persistent cough or chronic rash.

We think of television cops as believing in law and order, but if we seriously considered the matter, we would recognize just how foolish that is. They are no more, or less, likely than anyone else in Hollywood to be law abiding.

An ongoing scandal reveals just how disorienting it can be to have our illusions shattered. It is the case of Stephen Collins. In the popular Seventh Heaven series, he played the ideal father. A pastor, no less. We mourn for the lives he has injured, and we subconsciously grieve our own disillusionment.

The solution to the problem is not in ceasing to trust others. Life from that perch would result in paranoia and alienation.

No, I think that it still makes sense to trust—within limits. I am willing to extend my trust to someone in a respected profession who I have just met. That is based on the profession’s self-policing of standards.* Most require minimal education and competence standards, and have mechanisms for decertifying those who violate professional ethics.

Still, when time allows, the best advice is probably to “trust and verify.” The time I take to verify whether the person’s credentials or claims are true corresponds to the importance of what I’m entrusting to them. I would leave my car with a mechanic far sooner than I would entrust my child to a babysitter.

Returning to the case with which we began, we assume that a hospital is one of the safest places to be. And, even in light of the latest tragedy, this remains true.

For every one nurse tempted to end a complainer’s life early, there are a hundred thousand** who are striving to prolong the lives of their charges.

Trusting should not only be viewed as something we extend to others. Each of us would do well to ponder for a few moments just how trustworthy we are. This is especially true for those of us in privileged or respected professions. However, it is no exaggeration to say that the measure of any woman or man is determined by the degree to which they have earned the trust of others.

Lewis writes about the nature of trust, as it relates to friendship. It doesn’t relate to trust imbued in societal roles, but rather in the trust that exists where a relationship is already present. Still, he expertly describes the interplay between mind and heart, when it comes to trust. And this explains, in part, why the betrayal of our trust causes us so much anguish, in mind and soul.

To love involves trusting the beloved beyond the evidence, even against much evidence. No man is our friend who believes in our good intentions only when they are proved. No man is our friend who will not be very slow to accept evidence against them. Such confidence, between one man and another, is in fact almost universally praised as a moral beauty, not blamed as a logical error. And the suspicious man is blamed for a meanness of character, not admired for the excellence of his logic. (“On Obstinacy in Belief”).

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* The fact that some “professions” don’t have any mandatory requirements or standards, means that I remain wary when I meet people sporting those titles. For example, in America it’s possible to “ordain” oneself (or buy a meaningless diploma or certificate online). Thus, when someone tells me they are a minister, I am eager to learn more (about their education, congregation, accountability, etc.). There are far too many hucksters out there to take a person’s word for it that they are a genuine minister of God.

** Perhaps a slight exaggeration, but I’d like to continue believing that the ratio is something wonderful like that, 1:100,000. Then again, if I think of it literally, in terms of how many are “tempted” to expedite the passing of an inconsiderate and ungrateful patient, I imagine the numbers might be rather less encouraging.

Who Should We Trust?

March 24, 2014 — 14 Comments

staffordshire cross“You can trust me, I’m a pastor.” When I was ordained thirty-three years ago, that might have been sufficient to persuade many people to give me the benefit of the doubt. Not so today.

The latest Gallup poll records the continuing decline of our trust in “clergy.” Relentless negative press (much of it recording genuinely criminal and repellent behaviors) has taken its toll. Today only 47% of Americans trust ministers (of all faiths).

The good news, if you can consider it that, is that clergy still rank as the seventh most trusted group (out of twenty-two vocations considered).

But it remains quite pitiful. And quite understandable. Even being a pastor, there are many people considered clergy who I would not trust. First of all, anyone who purchased their “ordination” over the internet, and has the audacity to pretend to be a minister. I see a credibility gap there. (I would not include those who buy one of the fake diplomas as a “joke” to be untrustworthy . . . only those who pass themselves off as a “real minister.”)

I could go on, but my purpose here is not to trash clergy, since more than enough people already devote themselves to that purpose.

I am curious just who, in our increasingly uncertain and selfish world, we should trust.

I personally am in a rather envious position. I don’t have to rely on hoping people will trust me because I’m a pastor. I am also a sworn officer of the law. Albeit, I merely serve as a volunteer chaplain with my local county Sheriff’s Office, but we honestly do swear an oath to uphold the law, and we proudly wear regular uniforms, complete with our own chaplain badges (stars).

The thing about being in law enforcement is that I can benefit from the fact that it is the sixth most respected institution. So that carries me across the halfway mark all the way to the 54% trustworthiness milestone. I guess that’s fair, since I too place a higher trust in the integrity and professionalism of the average deputy or officer than I do in the average minister.

But, as I already said, I’m in a rather unique position, in that I also qualify for an even more respected category, that of a military officer. The 69% level of trust for military officers ties that of doctors and is only 1% below grade school teachers and pharmacists. So, I guess that if I want to instill confidence in my integrity, I’d best tell people that I’m a (retired) Air Force officer, and not that I am a member of the First Estate.

Trust is important. It’s a key commodity in any relationship, and absolutely essential for intimate relationships such as those shared within a family. Trust takes a great deal of time to build, and it can be shattered in just a moment. Its fragility is the primary reason why it must be treasured and guarded.

Trusted are those who never give others a cause to doubt them. My wife and I made a promise to our children that we would never lie to them. Never. We explained there would be times when we could not tell them something, or where we could only reveal a portion of the facts about a matter . . . but we promised them that whatever we did tell them would be the absolute truth insofar as we were aware.

Because of our honesty with them, our children (all adults now, of course), have been amazingly honest with us the whole of their lives. They trust us. We trust them. And none of us take that amazing gift for granted.

In Surprised by Joy, C.S. Lewis describes his introduction to J.R.R. Tolkien. Although the two would become lifelong friends, there were obstacles that needed to be overcome. One, described by Lewis, was that Tolkien belonged to not one, but two, categories of people who Lewis had been taught to regard as suspect. He was an atheist at the time, but it wasn’t simply Tolkien’s deep faith in Christ that gave him pause.

When I began teaching for the English Faculty, I made two other friends, both Christians (these queer people seemed now to pop up on every side) who were later to give me much help in getting over the last stile. They were H.V.V. Dyson (then of Reading) and J.R.R. Tolkien.

Friendship with the latter marked the breakdown of two old prejudices. At my first coming into the world I had been (implicitly) warned never to trust a Papist, and at my first coming into the English Faculty (explicitly) never to trust a philologist. Tolkien was both.

I’m not sure where philologists ranked on Gallup’s recent poll, but I am quite sure they did not include questions about different denominations or faith groups. Before ending these thoughts I suppose I should share with you the most trusted group in the survey—nurses. Eighty-two percent of Americans trust nurses. And I too would agree with that.

The matter of who we can safely trust is of great importance. In fact, it could be argued that it is the most important question in our lives.

Ultimately, even when we assure one another we will only speak the truth . . . even then we disappoint one another. Being human, we are finite, imperfect. We cannot always be there, even for those we love. Sometimes we fail to live up to our own standards and our promises dispel like a vapor in the wind.

Johnny Cash recorded a powerful song before he died. He had lived a rough and tumble life, and had found peace in a relationship with Christ. That peace, however, did not cure all of the ills or heal all of the scars he had experienced, and his profound familiarity with this world inspired the gritty lyrics of “Hurt.”

I wear this crown of thorns

Upon my liar’s chair

Full of broken thoughts

I cannot repair

Beneath the stains of time

The feelings disappear

You are someone else

I am still right here

What have I become

My sweetest friend

Everyone I know goes away

In the end

And you could have it all

My empire of dirt

I will let you down

I will make you hurt

In a moment, I’ll share a link to his performance of this moving song. But first, the answer to the question with which we began.

Who, exactly, should we trust? Johnny Cash learned the answer to that question, and so did C.S. Lewis. I trust the same Person that they did—someone who will never disappoint. Someone who cannot lie, since he himself is the Truth. As Paul wrote in 2 Timothy 2:

Remember Jesus Christ, risen from the dead, the offspring of David . . . I endure everything for the sake of the elect, that they also may obtain the salvation that is in Christ Jesus with eternal glory. The saying is trustworthy, for:

If we have died with him, we will also live with him;

if we endure, we will also reign with him . . .

if we are faithless, he remains faithful—

for he cannot deny himself.

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If you wish to watch the video of Johnny Cash’s musical epitaph, you can see it here.

The pectoral cross show above is part of the Staffordshire Hoard, which is the largest collection of Anglo-Saxon metalwork ever found. It dates from the 7th or 8th century.

Humor & Health

November 16, 2012 — 9 Comments

I had to have blood drawn today for an upcoming physical exam. It’s not one of my favorite things to do, but I consciously try not to allow my feelings to negatively affect the caregivers who provide these essential procedures for our wellbeing. (Trust me, dentists especially are sorely in need of our appreciation.) I often try to add a little smile to their day employing a touch of light humor.

Today, for example, I was repeating a blood test I had already accomplished earlier this week. When the corpsman (Naval hospital) asked which arm I said, “you better take it out of my left arm . . . they weren’t happy with the numbers in the sample they got from my right.”

Now, a modest joke like that won’t make it into any comedians’ monologues, but it did inspire a chuckle from the four of us in the lab at that moment.

It reminded me of getting my flu shot last year and having my choice of four different corpsmen to administer it. Each had a waiting line. I could only imagine what it was like to be puncturing one anonymous arm after another for eight hours. Most “victims” silent, but many grimacing and some feeling compelled to describe to you just how much they hate shots.

Three of the corpsmen were normal sized human beings. But the fourth was a behemoth. The seams of his uniform were near to bursting due to his extraordinary musculature. I doubt he was on steroids, but his massive figure could have fit into the offensive line of any team in the NFL. And, for some mysterious reason, his waiting line was the shortest.

When I approached him to receive my vaccination, I ventured (in a voice loud enough for his companions to hear): “I chose you because you look like you’re gentle.” Everyone got a laugh out of that, and I felt pleased at having momentarily brightened their day.

My kids are always wary when I make comments like this. They recognize that every time we open our mouths, it’s a gamble. We can achieve our goal, and elicit someone’s precious smile . . . or we can make a fool of ourselves.

As a grandfather, I have the added “protection” of not having too much expected of me, in the wittiness department. By the grace of God, I’m still in possession of the bulk of my mental capacities. I imagine that, should I live long enough, most of my attempts at humor may grow rather lame. But, if there remains any cultural respect for our elders, even these attempts will be recognized for what they are—goodwill. And, as such, there are those from whom they will still elicit a smile.

We should not be afraid of humor, especially in its most humble and intimate forms. Woven amidst the threads of our daily conversations, it enriches life.

C.S. Lewis recognized this quite well. In The Magician’s Nephew, which recounts the creation of Narnia, Aslan says to the newly anointed animals: “Laugh and fear not, creatures. Now that you are no longer dumb and witless, you need not always be grave. For jokes as well as justice come in with speech.”

Lewis notes something in Reflections on the Psalms that I too have found to be true. “A little comic relief in a discussion does no harm, however serious the topic may be. (In my own experience the funniest things have occurred in the gravest and most sincere conversations.)”

Because of this, it’s not uncommon when we sit with those who have lost a loved one, to find that the conversation often drifts towards those happy and humorous moments that were shared with the departed. I’ve heard much healing laughter in the still sorrowing presence of the grieving. And, whether the words or thoughts evoke bold laughter or simple smiles, I tend to consider them a good thing indeed.