Going to Heaven

Elliot at lunch time one day said:  "We're going to be with Jesus."

We were taken aback for a second, not sure where the statement came from.  Elaine said,  "Yes, Elliot, we will go to heaven some day."

Elliot's lower lip quivered.  "I don't want to go to be with Jesus!"  He said emphatically.

It turned out that Anna had been instructing Vince and Elliot on their futures.  Elliot had misunderstood and thought that he was going to heaven that afternoon.

Of course, people talk about heaven a lot and the fact that they want to go there when they die, but I think for most of them, they hope that day is a long ways off.  I suppose most of us want to go to heaven, we just don't want to have to die to get there.

And yet, if heaven is so much better than anything we can experience here on earth, wouldn't we want to go there?

Perhaps the biggest problem is that death seems so unknown.  We trust the seen, known life we live in the now rather than the unknown life in the here-after.

I don't know a whole lot about heaven.  It sounds pretty good in the Bible, but I imagine there's a lot of things left out in the descriptions there.  At the same time, my confidence isn't in a place with streets of gold, it is in a Heavenly Father who has never failed me.

While I don't know much about heaven, any place He is preparing for me has got to be pretty awesome.

Stained Hands

As I look at my fingernail beds today, they are dark and they have been that way since a couple of Saturdays ago.  Of course, my daughter Anna's fingers look worse than mine.

On Saturday, she and I peeled the hulls off of many black walnuts.  They still aren't cracked (that's a fun activity for another day), but they are ready to be.  Walnut juice stains really deeply.  Even after multiple scrubbings, the stain remains.

Last Monday, Anna's teacher even made her go wash her hands, because they looked so dirty.  I guess at least it's clean dirt...

I think of the verse from Psalms "Who shall ascend the hill of the LORD?  And who shall stand in His holy place?  He who has clean hands and a pure heart..."  This verse speaks of clean hands, but one can have filthy, walnut stained hands and still have clean hands before God.

The verse is clearly speaking of sin stains.  These are stains that go far deeper than even the subcutaneous layers.  These are stains that go to the heart.

There is a tendency to think that the remedy for sin is good deeds.  We just need to do more good than bad and that will clean the dirtied hands.  The only problem is that it doesn't work.  Sin stains are a lot more tenacious than even black walnut juice.

In the end, the only thing that will wash away these stains is the blood Jesus Christ.  For only the power in His blood can make my hands clean and heart pure before Him.

Catching Ebola

I read last week a survey of Americans that showed that they are moderately scared of getting Ebola, but that they have a lot of confidence that if they would contract the virus, they would be treated effectively.  In my opinion, that's a little backward -- I am not worried about catching Ebola, but would be pretty concerned if I actually contracted it.  But at least people aren't afraid of everything.

I suppose that's good, as it prevents panic in the streets (although not on Facebook).  Truthfully, for the tiny number of patients with Ebola Virus, who were treated in this country, the survival rate is pretty good -- far better than it is in the African nations dealing with the virus.

In the end, even in the United States, there is no "cure" for Ebola.  Infectious disease specialists have used HIV drugs, ZMAPP, and plasma infusions from Ebola survivors, but they cannot say for certain which of these things was, or will be effective.

I am afraid that modern medicine is too good at seeming like it has answers, even if it doesn't actually know very much.  The fact that we are doing "something," even if it is likely ineffective, gives people the illusion of control.

Much of life and health is actually beyond the control of humans -- even doctors who are specialists.  That is fine, because there are a lot bigger hands than ours in charge of this world.

I'm afraid that God has to bring us to the point where everything is spinning out of control, just so that we will give the control we never really had to Him.  For, when we are in God's hands, the wisest One in the Universe is in control of our destiny.  And even in the middle of an Ebola epidemic, that is a very safe place to be.

Making the Right Diagnosis

"The history is the most important thing!"

I still remember those words, spoken by one of my attending physicians in medical school.  An encounter with a patient is broken up into three parts.  The history, or what the patient tells the provider, the physical examination, and review of testing (labs/xrays).

Many believe that the physician should be like Sherlock Holmes, carefully inspecting the finger nail beds of their patients, looking at their tongues, and the soles of their feet.  Then, finally after a period of silence intone the fateful diagnosis:  "You, sir, have Tsutsugamushi Disease!"

It isn't that way.  I know about my patients from what they tell me and the key for me is listening.  Studies show that many doctors interrupt their patients within thirty seconds of them beginning to speak.  Doctors feel that they are "on the clock" and need to come to a conclusion quickly, so they can move on to the next patient. 

I feel these same time constraints.  Still, I have learned that if I let my patients tell the story in their own words, my patient tell me what I need to know in order to come to a conclusion and it really doesn't take that much time.

It isn't just about listening to patients either.  There are many people whose voices contribute to good care.  Nurses, techs, and medical assistants all tell me many things that I wouldn't know otherwise -- things that perhaps the patients wouldn't tell me, but share with them.  It may not even be symptoms, but other things, such as reasons why they aren't taking their medications or, family situations that are impacting their health.

I am just not smart enough to figure out every diagnosis without some help.  Even more, I can't always get a person the treatment that is best for them without understanding, not only their illness, but also, who they are.

It isn't easy to listen.  More often than not, when a person is speaking, doctors are figuring out what to say next or, the next question to ask.

In the end, listening isn't about me, it is about the person in the chair across from me, the nurse at the desk, or the patient in the bed.  As I listen, I will not only identify what my patient's illness is, I will learn who they are and understanding who someone is is sometimes one of the most important things to helping them find healing.

Lying to Your Doctor

A man diagnosed with Ebola Virus is under treatment in Dallas, Texas.  Two days before he was admitted to the hospital, he was seen in the Emergency Department with fever and abdominal pain.

Now, due to HIPPA, we are unlikely to know exactly what transpired during this visit, but it seems that the patient mentioned to the nursing staff that he was visiting from Liberia, but did not make further mention of it.  It is particularly clear that this Liberian gentleman did not emphasize to the physician that he was from Liberia or, that he had recently had close contact with a woman who died from Ebola.

I don't totally understand the rationale for not sharing this information.  I would have mentioned this several times just to be sure that the medical staff included it in the possible diagnoses, but maybe that's just me.

"Excuse me, Dr. Smith, but about a week ago I watched a lady die from Ebola.  I just thought I'd mention that."

I am always amazed by people who choose to lie to their doctor or, at the least, fudge the truth. 

I remember a woman with diabetes who brought in her sugar log books.  Carefully noted in the columns were various sugars, all between 90 and 140.  A couple of slightly elevated sugars -- 176 and 182 -- were noted with little notes:  "Ate at Golden Corral," or "Aunt Nellie's Birthday Cake."

"Looks good, Lynn," I said.

"Can I get you to cut down on my insulin dosage?"  She asked me quickly.

"Let's see what your A1C showed," I said.  I clicked on it and paused.  "Oh my, Lynn," I said.  "Your A1C test is 14.1."

"What does that mean?"  She asked.

"It means that your average sugar over the last three months has been a little over 360."

"Oh," she said and was quiet.

The whole log book was a complete fabrication.  There was no reason for Lynn to lie to me.  Even if I had no way of checking her average sugar, lying about it wouldn't change the fact that it was totally and completely out of control.  Lying about it wouldn't change the effects that the high sugar was having every day on her eyes, kidneys, and nerve endings.

Lying to your doctor doesn't hurt your doctor at all.  It just hurts you.

In the end, I am afraid that there far too many people who don't just lie to their doctors.  Many people deceive themselves and try to deceive their Maker too.  Of course, it never works, because no amount of lies can change the heart's condition.

In the end, honesty is not just the best policy, it is the only way to begin the path that leads to physical and spiritual healing.