The Importance of Doing What You Must.

“Don’t feel obligated.” I have said these words often to my employees when I ask them to do something extra. I say it because I do not want them to feel coerced or pressured to do something they do not want to so. Recently I have concluded that I am unintentionally sending another message when I use these words, a message that reveals something troubling about American culture- we think feeling obligated is a bad thing. We are wrong. People who only do what they want are very selfish people!

Not too long ago I was awakened at 4:00 on a Saturday morning by a message from my answering service. A patient of mine was in the emergency room with severe pain and significant urinary bleeding. The 43 year-old woman thought she was having the symptoms of a kidney stone and went to the ER in hopes of finding relief. The routine CAT scan revealed something much worse than a kidney stone. She had a tennis ball sized tumor in her kidney. The ER doctor was calling at 4 AM to discuss possibly admitting her to the hospital. As she was medically stable and it was highly unlikely that any surgery would be done that weekend we agreed that she could be sent home. I hung up the phone and prepared to go back to sleep.

The thought then came, “Should I go to the hospital?” There was no medical reason to go. She was stable and would be sent home. There was no medical treatment I could give. More thoughts came. She had been a patient for over 15 years. I had delivered one of her children and had cared for her and her kids for years. A devout Christian, I knew she looked up to me and trusted me. I also knew that she would be frightened and in need of comfort, of a type no other doctor could give. She needed her Family Doctor.

I sat for a few moments and debated what to do. I had not been sleeping well for several nights and desperately needed sleep. I told myself that no other doctor would go in to see a patient at that hour. In spite of my best efforts I could not shake the thought that I needed to go whether I wanted to or not. Somewhat begrudgingly I put on jeans and a sweatshirt and headed to the hospital.

After showing my badge to the ER clerk I made my way to her room. When I pulled back the curtain and entered she began to cry,“I told my husband that if Dr. Barrett walks in I will know it is bad,” she said. She trusted me so much, believed in me so much, that she was sure that if it was serious I would be there for her. She understood my need to listen to my heart, perhaps even more that I understood it. The fact that it was a sense of duty and obligation that caused me to come, that my heart was not fully cooperating when I left home did not matter. A sense of obligation began the process, my heart followed behind. Nevertheless my heart did follow. Her words erased any doubts that remained, I needed to be there.

I was not there long, just long enough to review her history, give her a hug and pray for her, but I was there long enough to make a difference. As I left I reflected on the truth that feeling obligated is not such a bad thing after all. Sometimes a sense of obligation is the first step in doing the right thing.

Why I can't Stand Kim Kardashian

When “I Love Lucy” hit the air in the 1950’s, Lucy and Desi had twin beds in their bedroom. It was considered inappropriate to show that a couple shared a bed, even when married! Watching TV today I marvel at how far we have fallen.

I recently changed stations while watching a new medical drama. I did not watch the show very long, but it did not take long to see that it had no moral standards at all. One of the plot lines revolved around two female friends, one of them who had just learned that the other was intimately involved with her ex-boyfriend. She asked her friend, “Why didn’t you tell me you were sleeping with him?” The friends reply, “Because we are not that serious.” Channel turned.

What does it say about a society when the single greatest act of physical intimacy is so meaningless?

It is so meaningless to Americans that we now make celebrities out of people whose only talent seems to be a willingness to buy expensive clothes and then take them off in front of a camera! (See Kardashian, Kim)

Those of us who care about marriage and family have a huge challenge ahead of us as we work to educate our children in the importance of morality and celebrity. We can start by being truthful about our culture and by celebrating those who manage to be faithful and moral, and by teaching our children that God values our insides, not our backsides!

- Bart

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Firm Rules that Make Life Better... and Easier!

I have been a faculty member in Family Medicine for the University of California, Irvine School of Medicine for 20 years. I have taught many students over the years and have been told that I have a reputation for being one of the most demanding teachers in the Medical School. I give more and longer reading assignments, have much higher expectations and am much more critical of student performance. In spite of this I am also told that students love the time they spend in my office. How can this be?

I think it is because everything I ask and everything I do when I teach is directed toward one goal- helping students become the best doctor they can be. The reading assignments are relevant and directly related to the patients and conditions they encounter. My high expectations are based in the belief that they probably know more and can do more than they give themselves credit for, and are geared to helping them perform not as students but as doctors. My criticisms are honest, direct and truthful, and are delivered with an absence of condescension. In this context students progress rapidly and see tangible growth over time. What initially might be thought to be a burden ends up being a blessing.

I wonder if this is analogous to meaning of the words of the beloved apostle John who wrote, “This is love for God: to obey his commands. And his commands are not burdensome, for everyone born of God overcomes the world.” 1 John 5:3-4 NIV

The commandments of God are not burdensome because they are not limiting but freeing. They do not keep us from experiencing the world but instead allow us to break free of its enticements and bondage and to experience the joy that only God can offer. That which to some might seem a burden ends up being a blessing. It is all a matter of perspective!

- Bart

Don't Make this Mistake in Marriage

I recently heard a devastating report about a Christian man I have known for a long time. A successful businessman who has been married for many years, I had always believed him to be a faithful man who was dedicated to his wife. I was wrong.

It seems that he fell  into a common internet trap. As it was the direct result of an immoral act on his part he could not blame anyone else for his mistake. He followed a link about meeting single women, going so far as to actually meet with someone. Common sense finally kicked in during that meeting and he went no further, but he went far enough to reveal disturbing and hurtful truths about his character and his thinking.

Beyond the obvious moral failings in his actions was the greater moral failing of his thoughts and attitudes toward his wife. In the statements on his profile and with his subsequent actions he declared to the world that his wife was not enough for him. He needed more. He deserved more and he wanted more.

How devastating this must have been to her. Any feelings of adequacy and security must have evaporated in an instant. I wonder if now when she looks in the mirror she is frightened by the changes age has brought or if she lies awake at night wondering what she did wrong. Even though her husband may not have committed the physical act of adultery the wounds to her heart are likely to leave permanent scars.

As I think about their story I naturally reflect on my own marriage and am grateful for a blessing that is often overlooked by others, the blessing of contentment. I am completely fulfilled in my marriage. My wife is all I need, all I want and all I could ever want. She is everything and more to me and she knows it. Because I am content I feel no need to look elsewhere, no reason to think the grass is greener beyond any fence.

I am of the opinion that contentment in a marriage is one of the greatest gifts a spouse can give. It brings peace and security to both husband and wife. Its absence  indicates deep problems in the relationship. If you are not content in your marriage, take a step back and ask yourself, "Why not?" As you do, don’t look at what is wrong with your spouse, look at what is wrong with yourself. Why do you want more? Why are you not satisfied with the spouse God has given you?

If you want to gain or maintain contentment in your marriage, take time every day to thank God for your spouse. Make a list of all of the blessings in your life that have come from your husband or wife, making sure that number 1 on the list is- “Thank you God, that they put up with me!”

- Bart

PS: Today marks 32 years of Lisa putting up with me! What a blessing! If you have been touched by this post in any way, please share it with others. You never have to miss a post, you can have them all delivered to your email by subscribing to the blog! Just click on the subscribe button. (upper right on a computer, at the bottom on an ipad or smartphone)

"Have you Killed any Christians Lately?"

I ask a LOT of questions every day in the office. Most are routine and expected, questions such as “Where does it hurt?” or “How long have you felt this way?” Of all the questions I ask, few are as impactful as the one I asked not so long ago, “Have you killed any Christians lately?”

The patient has been in my practice for a while and is well-known and well-liked by the staff. Her visits have been more frequent as of late as she has struggled to deal with a lengthy illness that has made it impossible for her to work. Anxiety and depression have overwhelmed her. I started antidepressant medications a few months ago with no visible response. She was not doing well.

One look at her face when I walked into the exam room told me that the most recent medication adjustments were not working. Her face revealed her anxiety and sadness. I asked her what was going on and she shared that she had started drinking again, heavily. I had to ask her several times before she would tell me exactly how bad the problem was. She was binging, drinking as many as 18 beers in a day. In my mind I ran through possible reasons for such a sudden increase in drinking, remembering that binge drinking can be associated with the manic phase of bipolar disease and that anti-depressants can send a bipolar patient into mania. I wondered, "Maybe she isn’t simply depressed. Does she have Bipolar type 2? (Bipolar type 2 is a depression dominated form of bipolar disease.)  

Bipolar disease would explain the poor response to anti-depressants and the drinking. With this in mind I asked about other signs of mania such as poor judgment and impulsive behavior. “Have you been making any other poor decisions in your life? Spending money you do not have or being more promiscuous?”

Tears immediately filled her eyes and flowed down her cheeks. “Just this weekend,” she replied. She went on to tell me about a sexual indiscretion, an encounter she normally would have avoided. I knew it pained her to share this with me as she had made many statements about her faith in previous visits and the behavior she described was completely opposite the faith she had professed. My heart ached for her. I knew that her mental state must have been truly weak for her to engage in activities that were in such blatant opposition to her beliefs and values.

I tried to proceed with gentleness. I encouraged her to seek out a psychiatrist, sharing my concerns that she may not be on the best medications for her. Because she was doing so poorly I encouraged  her to get a second opinion as soon as possible. Before she left the room I gave her a hug and told her to take care of herself. As we stepped into the hallway she turned back to me. The tears returned and her shoulders quivered as she said, “I am so embarrassed and ashamed!”

I pulled her back into the room. “There is no place for guilt. We all make mistakes,” I said. “If you are worried about having messed up, take a number and get in line. Behind me! We all mess up!” I shared that while we each may struggle with different sins, we ALL struggle with something. (My personal struggles are a "wonderful" combination of insecurity, impatience and anger.)

“But I have done such terrible things!” she responded.

Then came the question. “Have you killed any Christians lately?” A puzzled look came over her face. I reminded her of the story of the Apostle Paul, who prior to his conversion to Christianity was actively involved in persecuting Christians and having them put to death. “God forgave him and he became the greatest evangelist ever. If God can forgive Paul killing Christians he can forgive you.”

The flow of tears slowed as the meaning of the words sunk in. I encouraged her again to see the psychiatrist, and to talk with a pastor. “There is no shame in needing help or in asking for help! We all need help. If you refuse to admit you have a problem and refuse to get help I will let you feel ashamed about that. Otherwise shame has no place!"

A few minutes and another hug later I sent her on her way, praying that she would experience the peace that comes from forgiveness, both the peace from being forgiven by God and the peace that comes from forgiving herself.

Next time you are down on yourself and wonder how God can ever forgive you, take a moment and remind yourself of God's capacity for grace and forgiveness. You probably have not killed any Christians lately! It is not about how "forgivable" we are. It is about how forgiving He is. 

-Bart

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