Parenting by iPad

I see it more and more in the office. Little children with an iPad or an iPhone in their hands. Some are too young to speak in full sentences yet they can clearly communicate their desire to watch a movie or play a game. Mom and dad rapidly comply with their wishes as it accomplishes their primary objective, a quiet child. While I can understand the desire to be able to interact with another adult without being continually distracted by your child I fear that there are unintended consequences ahead for these parents and children.

My concerns are increased by how often I see  this parenting behavior outside my office. It can be seen almost anywhere we see parents and their children. Children riding in the child seats in shopping carts, at tables in restaurants, in church pews and even at family gatherings can be seen sitting alone staring at a miniature video screen. The children appear to be happy, content and quiet, yet I wonder. When did quiet children become the ultimate parenting goal?

While the unending questions of a toddler can be wearisome, they are an essential part of intellectual and social development. Through them the child learns not only how to speak and communicate but also how the world works. These repetitive conversations help forge a relationship of trust and respect with parents. Parents learn the personality and interests of their children and strengthen the bond they share. Children learn from what goes on around them. They learn appropriate social interaction from watching adults interact. They also learn patience and self control. None of this happens when the child sits in a corner with an iPad.

While a child's quietness may make a parent's life easier for the moment, this is not a healthy goal. Good parenting has never been easy. I fear that the current generation of parents has either never learned or has already forgotten that we do not have children for ourselves. Children are not toys or playmates to be called upon when entertainment is desired. They are a gift from God, made in His image, given to parents to be loved, trained and served. Children need parents who will sacrifice for them, who will answer the repeated questions and play the silly games, who will love them, listen to them and give them attention.

There is no app for that.

- Bart

Thanks for reading and especially for sharing posts with others. Questions and comments are welcome. I can be followed on twitter @bartbarrettmd, you can also find me on vimeo (vimeo.vom/bartbarrett) or get posts in you mailbox by subscribing to the blog

Lasting Pain, Enduring Hope

I wear a knee brace almost every day now. I hate  wearing it but I hate the pain more so every morning before work I strap it on. It makes my pants bulge and my ankle swell but it takes some of the pressure off of the arthritic medial compartment of my knee joint. Most of the protective cartilage on that side of the knee has eroded away and my treatment options are limited. The hope is that in addition to relieving the pain and allowing me to walk and exercise the brace will slow the progression of the arthritis and delay knee replacement surgery for several years.

It has been a difficult mental adjustment. It seems like only yesterday that my legs were the strongest part of my body. It would be better to say they were the only strong part of my body, for when I first joined a gym at age 19 I couldn’t bench press much more than 100 pounds but I could leg press the entire weight stack. I wasn’t strong but I was quick and light on my feet. I played in softball and basketball leagues and loved it.

I did not know it but sports playing days were numbered. The decline began when I tore an anterior cruciate ligament playing flag football in medical school. I was a slow learner, as 6 surgeries over the next 14 years did not teach me that I should avoid flag football. I tore my other cruciate ligament playing flag football with friends on New Year's Day 1999. At the age of 38 I should have known better.

When I tore that knee ligament I also tore my medial meniscus, the shock absorbing cartilage inside the joint. In 1999 the treatment was surgical removal of the damaged area. Doctors now know that removing a meniscus leads to arthritis later in life. I was smart enough to know that I could develop arthritis in the future but I never expected the future to arrive so fast. Arthritis has arrived and my life has changed dramatically. In the summer of 2014 Lisa and I would take nightly walks down to the beach, walking a 3-4 mile loop. It was the highlight of every day. This last summer I never even tried it. It was not worth the pain.

The arthritis has brought with it something else I did not expect. It has brought a sense of mortality and an awareness of age. I am almost 54 years old and have been married for 33 years. I am dealing with the reality that my life is halfway over and that another 33 years are by no means guaranteed. I have found myself wondering what I will be able to do when I get older, whether I will be physically able to do all of the things that I want to do, even most of the things I will need to do. The clock is ticking.

I see my older patients differently now. I recently met a new patient who at the age of 75 cannot walk across the room without experiencing severe pain in her arthritic knee. Her heart, lungs and mind are healthy but they are trapped in a body that cannot walk around the block. Cooped up at home, she is isolated, lonely and battling depression. After hearing her story I had my staff call an orthopedist to get her in for a visit as soon as possible. I did not want her to have even one more day of pain.

My pain has impacted my faith as well. It serves to remind me of the futility of pursuing earthly success. No amount of effort can change my ultimate physical reality. No matter how hard I try I have to accept the truth that we all get old, we all break down and eventually, we all die. My only hope for enduring health and happiness lies in the next life, not in this one. I have always known this but living with pain is an effective reminder of the truth expressed by the Apostle Paul- “that our present sufferings are not worth comparing with the glory that will be revealed in us.”

Paul's words are encouraging. The sufferings of this life are real and can seem overwhelming. Paul tells us that the joy and glory that await God's children is exponentially greater than the pains we endure now. My pain causes me to consider and embrace the eternity that awaits. This pain enhanced understanding of life brings hope instead of despair, for this is what looking forward to eternal life brings. 

-          Bart

Thanks for reading, and for sharing with others. Comments are welcome.

The Foolish Immorality of Sean Penn

If you were given the opportunity to meet with a vicious criminal, a drug dealing murderer responsible for the deaths of hundreds of innocent people, a recent prison escapee who was a fugitive from justice and who had recently escaped from prison, what would you do?

If you are Sean Penn, you covertly accept the invitation and evade detection in order to meet with the man. You pose for pictures shaking his hand and write a story for a national magazine. You then give the criminal the final edit of the story so he can be sure he is portrayed in a favorable light.

And, because you are Sean Penn, you can be certain that you will face no criminal charges and will suffer no damage to your reputation or future acting opportunities as a result of your arrogance. In the western world, rules and laws are for the little people, not for celebrities.

As I read the story of Mr. Penn’s interview with the Mexican drug lord El Chapo I wondered how we arrived at such a place in our society. I am not so naïve as to expect perfection from famous people but I did expect them to possess some form of a moral compass, to care at least a little about being at least a little bit truthful or nice. I did not think that even the most low-life of celebrities would be supportive ofthe mass murdering head of adrug cartel.

I guess I was foolishly optimistic. I should have known that a man who had been fawned over for his entire adult life and whose talent gave him access to world leaders and power brokers would think he was entitled to meet with anyone he wanted for any reason at any time. Sean Penn was curious as to how a man like El Chapo came to be and his curiosity was all that mattered. Curiosity was more important than justice and fairness or right and wrong.

As I read about Penn and El Chapo the thought occurred to me that we may have cultivated a generation of Sean Penns. Many young people I meet are driven by personal desire more than they are by a moral code. There is no sense of duty to society as a whole orto anyone else individually. This is why so many in the current generation feel comfortable building up massive debt they do not plan to repay, using illegal drugs without regard for the law or future physical harm, orlying in order to get a job they want or a sexual partner they desire. Wanting something is what matters and when something is wanted there is no need to consider if it is right or wrong.

This type of thinking is the natural outcome of the post-modern thinking that dominates the modern world, a philosophy that denies the existence of absolute truth or a transcendent moral code. When we throw away external standards, when every person decides for themselves what is right and wrong, it should not surprise us if we are surrounded by fools like Sean Penn.

While there is nothing I can do to impact Mr. Penn's thinking, I am not hopeless. I have raised children who know the difference between right and wrong and I do all I can to remind others that absolute truth exists, that there is a God and that He has communicated His moral code to mankind. (I have even written a book about it!) The lie of post modernism needs to be exposed, countered and attacked. When truth is lost, only foolishness remains.

- Bart

Remember you can subscribe to the blog by clicking the subscribe button. Questions and comments are welcome, and those who share posts with others have my undying gratitude!

Photo by Seher Sikandar for rehes creative licensed through creative commons 

The Responsibility Leaders Avoid

In any job or position there are duties that are challenging and difficult. The temptation to set these tasks aside or to only partially complete them is difficult to resist. It is difficult, but for those in leadership it is important. 

One of the most challenging responsibilities of a leader is the need to discipline or rebuke a member of the leadership team who is failing. Whether the failure be work related or a matter of morality, leadership failures can do great harm to an organization. Allowing such failures to continue is inexcusable. It is inexcusable but it is unfortunately common.

This failure to address sin in leadership is not a recent phenomenon. There are stories of leadership failures dating back hundreds of years. A particularly sad tale of such failure can be found in the Biblical book of 1 Samuel. There we read of a man named Eli who was the chief priest for the nation of Israel. His two sons were serving as priests under him. His sons were immoral men who stole from the offerings brought by the people and who had multiple affairs with the women who served in the tent of meeting.

Multiple reports came to Eli telling him of his son’s terrible deeds. Eli spoke to his sons about their behavior. He told them that he had heard of their sin and how news of it was spreading among the people. He warned them that God would judge them for their actions. Unfortunately, Eli did nothing but talk. He did not remove his sons from their positions of authority or punish them for their deeds. Ultimately Eli and his sons paid for their sins with their lives and the nation suffered tragic defeat at the hands of its enemies. Thousands died.

I have seen similar failures in multiple settings in medical organizations and in churches. I served for a year in a leadership position for a large hospital in Orange County. I watched first hand as the CEO intentionally misled and manipulated others. I soon learned that the instances I had seen were not isolated. Medical staffs leaders and hospital employees related similar tales of promises broken and respect lost. In conversation after conversation people expressed the same question, "How could the Board of Directors not see what was happening?" The greater fear was that the Board did see but was refusing to act. The CEO moved on (he was actually promoted!) to another position but it will take years to rebuild the trust and confidence that was lost. It has been over three years since I dealt with the man and I still do not fully trust the leadership of the hospital and am extremely cautious in all of my dealings with them.

Such failures of leadership are sad in business but they are tragic in churches. Over the years I have seen church elders follow in the steps of Eli on many occasions. I have watched as elders acted as if the fact that an in issue had been discussed meant that it had been addressed. I saw this again recently in the way leaders of a particular church dealt with a pastor who frequently used foul language and was overbearing in his dealings with staff members. The elders knew of the behavior and “addressed it” but continued.

The pastor ultimately resigned for other reasons. As he left failings were hidden further when the elders publicly praised him as a great man on his final Sunday at the church.

As is always the case, the secret of his poor character did not stay secret long. His poor judgment and lack of repentance became evident in his podcasts and Facebook posts. Freed from the constraints of his church position he shared his salty language and questionable theology with the world. He has left his church but the damage his sin caused continues to this day as left behind a divided congregation.

The stories of the CEO, the pastor and Eli the priest are powerful reminders of the tremendous responsibility borne by all leaders. It is up to leaders in business to step up and address failures of leaders and it is up to church elders to shepherd and protect the church, to stand against those whose acitions can cause harm. There are few duties more important than holding other leaders accountable for their words and deeds. When dealing with leaders who are failing mere words are seldom enough. Action is required.

It is difficult and uncomfortable to take such action but true leaders rise to the occasion. 

-Bart

Things that Make You Go '"ARRRRRRRRRRGH"

I struggle with stupidity. When confronted with asinine policies, procedures or responses grace goes out the window and I become an impatient, short-tempered jerk. I tell myself that I will do better the next time, but each time the next time comes I find myself struggling all over again.

One of my greatest frustrations is the number of useless forms that have become a part of my life. I somehow missed the memo, but last week must have been National Stupid Form Week.

CVS Pharmacy interrupted my day demanding to know the diagnosis for a patient being prescribed narcotics. While they say they are trying to stop fraudulent prescriptions, my prescriptions are sent through a secure electronic system that is double password protected. One of the passwords changes every 30 seconds, so fraud is impossible. This did not matter to the pharmacist, who had a form to complete.

A perfectly healthy patient came in with Federal Family Medical Leave Act forms from her employer. These forms are to be completed when patients have a serious illness that requires an extended absence from work. She had missed three days with a stomach flu so the forms did not apply. This did not matter to the Human Resources person who apparently could not take any action or make any decision unless there were forms attached.

A Plastic Surgeon’s office sent over forms for “pre-operative clearance” on a perfectly healthy 40 year old man who was getting his nose fixed. The medical literature is replete with studies and guidelines stating that such clearances are worthless and should not be performed. This does not matter to surgical schedulers. They need a form.

A medical supply company sent over forms for new CPAP supplies for a patient with sleep apnea. They needed me to write out an order for new supplies (they are replaced annually) and to submit an authorization to the insurance stating that they were needed. For the insurance I need to include the diagnosis and supporting documentation. Sleep apnea is a chronic disease that never goes away, the diagnosis never changes. The patient has had the disease for years and all of the documentation has been previously sent. This does not matter, as to dispense the supplies someone needs to complete a form.

My problem is that I resist. I try to point out to the person requesting the information that the form is useless and unnecessary. This does not compute. Their request is not a result of reason or necessity. It is a matter of policy. Trying to change a policy is futile. I would have more luck arguing with my dog about eating food dropped on the floor.

I have realized that if I try to change these policies, as foolish as they are, I will end up frustrated, angry and responding in a very non-Christian fashion. Since arguing is pointless and wastes so much of my time I have decided I have only one option left.

I have my nurse do it.

- Bart

You can subscribe to the blog by clicking the button on the page (upper gift on a computer, scroll down on a mobile device.) Comments and questions are always welcome. You can also follow me on Twitter @bartbarrettmd