Suffering for Christmas

I have seen a lot of suffering lately.

The week before Christmas a patient I had known for over 15 years was sent home from the hospital on hospice. His bone marrow cancer had left his bones and attacked his liver. It was too late for the bone marrow transplant he had been waiting for and too advanced for any hope of a response to any treatments. Within 24 hours of going home he was confused and difficult to arouse. He died less than a day later.

I had another patient go home on hospice Christmas eve. The combination of metastatic cancer and heart disease had left her too weak to fight. As it was possible this Christmas would be her last she chose to spend it at home. She still holds out hope that she might regain enough strength to resume curative treatments but there are no guarantees. Hers was a sick Christmas.

On December 23rd I made a house call on a third hospice patient. This patient has an incurable lung infection. We thought it would have taken her life months ago but she has hung on, her body refusing to give up on the unwinnable fight even though her mind did long ago. Walking across the room can be an ordeal for her. The disease has destroyed so much lung tissue she has no respiratory reserves remaining.

All three of the patients and all of their families suffered this Christmas. The emotional and physical pains were real and intense. In addition to their hospice status they had something else in common, the lingering question, “Where is God in all of this?”

Modern society, and at times the Christian church within it, seems to have the view that suffering has no rightful place in this world, that its presence is evidence that God either does not exist, does not care, or is weaker than is claimed. The thought that a good God could allow suffering, or worse, ordain it, makes no sense to us.

When Christians do talk about suffering it is usually discussed as a temporary stop on the journey to a positive destination. This is often true. My own life is evidence of this reality as my struggles with chronic pain and anxiety have helped soften and mold me into a more patient and caring man. What is seldom discussed or acknowledged in the Christian faith is the suffering that endures, the pain that never fades and is a permanent part of someone’s life.

It is seldom discussed but it is readily evident in the world around us. Whether it be from conditions such as fibromyalgia or Lou Gehrig’s disease or oppression under hateful governments there are millions of people around the world who wake up each morning in the same state or worse than they were the day before, with no end in sight and no hope for better days. What is God’s purpose for these people? Why do they continue to suffer when there seem to be no further lessons to learn? Why does not God rescue them from their pain, allow them to go on the next life now?

These questions returned to my mind this week as I was reading through the book of 1 Peter. Peter was writing to Christians in Asia who had experienced severe persecution under the Roman emperor Nero. Many Christians had been killed or tortured and the ones that remained lived in fear of the same. Peter wrote to educate and encourage these people in the truths of God.

The most astonishing aspect of Peter’s letter was his attitude about suffering. Peter wrote that, for these people at least, suffering was not something to be temporarily endured but rather a calling to be accepted. Peter told the people of the eternal nature of their call, of the profound blessings that awaited them in the next life and the certainty of them receiving them. He reminded them that Jesus was called to suffer on their behalf and that they were called to suffer as well. He then made the remarkable point that the manner in which people endure prolonged suffering is a powerful testimony to others.

As I read his words I realized that they are in profound contrast to what many Christians seem to believe. When suffering comes we spend our days praying for relief, looking for a lesson or hoping for a way out. Peter’s words remind us that none of those options may apply in this lifetime. At times the only purpose for our suffering is that God be glorified by the manner in which we endure it.

Not a truth I particularly like, but a truth I need to accept.

Bart

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Peace on Earth in a World Filled with Conflict

The words are repeated every year at Christmas in word and song, “Peace on Earth, Good will to men.” It is a beautiful sentiment, but as with many Christmas proclamations for some its meaning has been lost after centuries of repetition. God gave the angels these words to describe the good news of the Savior’s birth so it seems they are important enough to reflect upon at Christmas.

In considering these words the first thought that comes to mind is that they do not appear to be entirely true. For most of human history there has not been anything close to “Peace on Earth.” War is a perpetual reality. A review of history reveals that at any given point in time there is at least one group of people trying to kill or conquer another group of people. One is left to wonder, “Where is this peace promised by the angels?”

Clues to the answer can be found in the source of the proclamation, the angels who appeared to the shepherds on Christmas night. Their nature and identity shed light around the shepherds then and shed light for us now.

Luke, in his gospel, describes the angels in this way-

“And suddenly there was with the angel a multitude of the heavenly host praising God and saying, Glory to God in the highest, and on earth peace among those with whom he is pleased!"

 “A multitude of the heavenly host” appeared.  A clearer description of these individuals is found in Wuest’s expanded New Testament, where he translates the phrase, “a multitude of the army of heaven.” Wuest was on to something. It was not a choir that appeared. The word “host” is a military term used to describe the soldiers of an army. Standing on the hillside that first Christmas night was no angelic choir. It was the army of the Living God. They were there for a reason. It was not by accident that God sent his army to proclaim “Peace on Earth.” Their presence on the scene has tremendous meaning.

The army of God is described in a number of places in scripture. In the Old Testament it appears on the scene to defend the prophet Elisha from the Assyrian army. (2 Kings 6) In the New Testament, this army returns at the end of the world to carry out God’s judgment. It is this last job description that is most significant with regards to the Christmas message. The message of peace was proclaimed by those who will one be the agents of God’s wrath. At the end of the age God will send His armies to wage war against not only the devil, but against all of disobedient mankind. The battle into which this army will be sent is God’s battle against sinful man.

The presence of the Army of God reminds us of the conflict addressed by the birth of the Savior. Since the fall of man, the original sin, Mankind has been at war with God. The universal peace lacked by all was peace with God. Unless something happened to restore this peace the wrath of God would fall on all people.

On that first Christmas night the solution to the conflict was proclaimed. The one who would resolve the conflict had been born, the Prince of Peace. The army of God arrived on the scene and with their presence reminded all of the wrath that was coming and that was deserved. In their words they proclaimed the reality of how the wrathful hand of God would be stayed. In response to the birth of Jesus they laid their weapons down and proclaimed, “Peace on Earth, goodwill to men.”

This is the message of Christmas. Our world is sinful and fallen, deserving of destruction at the hands of a holy God. As deserving as we are of such punishment, we need not experience it. For on that day, in the city of Bethelehem, was born a Savior. The One who would one day take the wrath of God upon himself and open the door to everlasting peace.

Merry Christmas

-          Bart

Breaking Families with an iPhone

Illuminated screens are harming children. One study estimated that children between the ages of 2-5 spend 32 hours a week in front of a TV, an average of over 4 hours a day. Kids between 6-11 spend 28 hours a week watching TV, as well as additional hours on hand held devices and video consoles.

It is felt that the screen epidemic is the causative factor in a multitude of health issues, from ADHD to childhood obesity. Additional concerns have been raised about the content of what children watch. Television programs can reinforce negative stereotypes and contradict the values parents want to teach their children. Even when parents install internet filters, handheld devices with internet access can lead to children being exposed to adult content.

In response to these and other concerns the American Academy of Pediatrics has come out strongly in favor of limiting the amount of time children spend looking at screens. Recommendations are that the total time looking at screens of all types should be less than two hours daily. This is a good start but may not go far enough.

In spite of all of the data and research there is one aspect of children and screens that is frequently overlooked. Their parents are spending too much time looking at screens when they should be looking at their children. I saw this first hand this week while walking in the park near my home.

I was walking near the playground when I came across a father with a young boy. A bicycle on the ground near them revealed how they had arrived at the park for their Sunday afternoon outing. The child, who looked to be about 4 years old, was playing at the edge of the sand near where the playground equipment was located, drawing in the sand in the stick. The father was 6 feet away, lying on his stomach in the grass, thoroughly engrossed in his iPhone, paying no attention to what his child was doing. He was more interested in what was on the screen then he was in what his son was doing.

The father reminded me of how much we have lost to our screen obsessions. I wonder how many conversations have been skipped, how many stories gone untold, how many jokes unshared, because either the parent or the child was looking at a screen. It seems that the American Academy of Pediatrics is on the right track with their recommendations but it is too narrow. The limit should be extended to parents as well!

- Bart

Prayer as Medical Treatment

Her head had been in near constant pain for over 3 weeks. She had endured migraines for years but they had been rare and relatively brief. The pain was not making it difficult to sleep and function, work was out of the question.

This was her 4th visit in the office in a 2 week period. I had prescribed pain medications (which made her vomit), medicines to abort migraines (which had minimal benefit that did not endure) and had even stayed late one day to administer a steroid shot (which was a long shot at best). When I walked in the room the tears in her eyes and the strain on her face told the story. She was emotionally done, the end of the rope had been reached. She wanted help.

Unfortunately I did not have much to offer. All of the options for immediate relief had been exhausted. The next step would be to start daily medications to prevent headache, but these medications can take several weeks to be effective. I ordered a CT scan of her brain, which although medically needless was emotionally necessary to calm her fears and wrote the prescription for the daily medications.

Out of options, as I was bringing the visit to a close I asked, “Are you religious at all? Do you practice any faith?”

“Not really,” she said, “I went to Catholic school though. Why do you ask?”

“Nothing else has worked, so I was going to offer to say a prayer for you,” I replied.

“I’m not religious,” she said, “but I would welcome you saying a prayer right now. I will take whatever help I can get.”

I walked across the room and put one arm around her shoulders and said a simple prayer, “Dear God, Amber is hurting right now. She is frustrated and exhausted. Give her hope, give her peace, and giver her relief from pain. Amen.”

I had been taught In medical school I had been taught to never inject faith into an office visit and to never allow my faith to intrude into my care. Her acceptance of the hug and the prayer proved my former teachers wrong. Faith, expressed as love and concern for a person in need, always has a place.

Bart

House Calls of Death

He was serious alcoholic. His disease was so severe, his addiction so powerful, that 21 stints in rehab had failed. His marriage had fallen apart, his children had been taken in by his parents, he was unemployed, lonely and miserable. He was 41 years old and in his mind his battle against alcohol had been permanently lost. He gave up any hope of recovery and went to his primary care doctor looking for a special kind of help. On July 14 of this year his doctor gave him the “help” he requested. His doctor killed him.

The patient, Mark Langedijk, lived in Holland, the country with the world’s most liberal euthanasia laws. Physician administered death is common there, in 2015 more than 5500 Dutch citizens had their lives ended at the hands of a doctor. That calculates to about one of every 2000 Dutch adults. In Holland, having your life ended by a physician is not a rare event. 

The law, as originally introduced 16 years ago, was purported to be about allowing patients with terminal diseases to choose the timing and means of their own passing, a way for patients doomed with incurable and progressive illnesses to control their destiny and avoid needless suffering.  That is not the current reality. The scope of conditions for which physicians are allowed to give lethal injections has widened considerably. A young woman in her 20’s struggling with post-traumatic stress disorder from child sexual abuse was recently determined to have mental suffering severe enough to justify ending her life. A physician injected her with heart stopping medications.

An increasing number of states in the US have passed laws for physician assisted suicide, which makes the Dutch experience all the more sobering. All of these state laws were advanced with the same arguments and promises given in support of the laws in Holland.  Opponents of these laws who feared widespread and inappropriate use of euthanasia were accused of lacking compassion for the suffering of others. Proponents of these laws consistently argued against “slippery-slope” arguments, saying that controls and limits were included in the laws to make sure they would not be abused.

The reality is that slippery slope arguments are always valid. When society moves in a direction it typically continues in the direction. The debate is not about whether we will move towards greater use of euthanasia, that will happen. The only question is the steepness of the slope and the speed of our descent. When a society crosses the line and says that some lives can be terminated they have embraced a system in which society has the right to determine which lives are worth living and which are not. The stories from Holland remind us that once that line has been crossed,  that over time more and more lives will be determined unlivable and more lives will be ended by physicians.

If there is no course correction, Americans will one day wake up in a world where death doctors are performing house calls, a thought which should be sobering to us all.

Bart

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reference- The Daily Mail November 30, 2016