Small Packages

 

"I want to see her teeth!"  Elliot said emphatically.

"Well, dear, she doesn't have any yet,"  Elaine told him.

His sister walked over.  "Victoria can't bite you, because she doesn't have any teeth!"  Elliot told her, as if this was the most important thing to settle.

Our household is still getting adjusted to a tiny package that was delivered just a week ago, after a nine month wait.  This tiny package has a name.  Victoria Grace.

As I think about my small daughter's arrival, it brings certain things to my mind.

Anything worth having is worth waiting for.

I don't know that any of us would have wanted to wait for ten months for her to arrive, but we certainly didn't want her to come any sooner than she did.  Something about waiting for her makes us love her even more, now that she is here.

The best things in life are often contained in the smallest of packages.

Victoria Grace weighed just 6 lbs 11 oz, but, she brought an amazing amount of joy and change within our home. 

It doesn't change a mother's love one bit if her baby only weighs a pound or two at birth.  The blessings are still there, the prayers are more constant, and the love even deeper, if possible, as she watches her little one fight back from prematurity.

Just because something happens normally a hundred times does not make it less of a miracle.

I have attended many deliveries in my time and perhaps by now, it should be stale.  Just one more baby entering a fairly well populated world.  But it isn't stale at all.

For, we are fearfully and wonderfully made and God's hand is clearly visible from birth on. 

As I stand by the basinet of my children and of other children that I have delivered, I silently pray a blessing on their lives.  It is a dark world.  There is much fear and hate and suffering.

I pray that in this, they might find God's light and Christ's love.

I pray that they would grow up to share it with others.

Even, share it with those who have no teeth.

Spring Peepers

A couple of weeks ago, snow filled the air and the temperatures plummeted to below zero.  Crazy weather for the first week of March in southern Indiana.  Then, scarcely a week later, it was sixty degrees and my children and I were running around outdoors without any jackets on.

That's when I heard the sound.  High pitched.  Fluctuating a little.  It is a sound that always brings a smile to me face.

The sound of spring peepers.

It is no bird that sings so loudly.  This sound is produced in the throats of many, many tiny frogs, barely an inch long.  Sitting in the mud, they raise their voices to say that yes, spring is on its way.

These are tiny creatures.  Each one with its little voice that has very little impact.  And even though it is swallowed up in the sounds of a huge Universe, each one still sings.

They are not singing to impress me or, other humans.  They are not even singing to other frogs.  They are singing because God made them with that one talent and they will use it to their utmost, for Him.

There are many times that I feel my voice is weak and far from beautiful.  There are times that I feel that my talents aren't very useful.  And yet, I still would praise my Maker, while I've breath.

It isn't for the other humans around me or, even to lift myself up on some emotional high, that I sing.  Rather it is for an audience of One, who is my focus.

It is a huge Universe and I am small.  No one has ever yet paid to hear me sing.  Still, God hears and hears the thought and the love behind my song.

And He accepts it.

That's why the Spring Peepers sing.

That's why I sing too.

The Wages of Dieting

The man sitting across from me cleared his throat uncomfortably.  "Well...” he said in a grumbly sort of voice that told me that he didn't like the subject of our current conversation.

We were talking about his diabetes and how he was following his diet, which I could tell by his reaction, he wasn't.  I flipped open his chart to look at the lab results that it contained. They told the story themselves.  His blood work had consistently increased since his diagnosis of diabetes 3 years previously.  The medications had initially made a big impact, but now, they seemed to be doing very little.

Kenneth cleared his throat again and began telling me the story about some man who came over to his house every evening to eat supper.  I couldn't see what it had to do with everything else that we were talking about, but I didn't want to cut him off either, so I listened, less than raptly.

"Yup," Kenneth was saying  "He comes over every evening whether I invite him or not.  He's an old guy and just as cheap as they come.  Why he wouldn't even pay to have his wife get a proper head stone.  Just got the cheapest thing they would give him and stuck it in the cemetery...” I wondered idly if it was worth saying anything more about Kenneth's diabetes or if it was a lost cause.

Kenneth continued "Last night I made a cake..."

"With real sugar?"  I asked.

"Yes,” he answered brazenly enough. "But I only had two small pieces and then Bill came over and wondered if I had any sweets in the house.  Well, I told him I did and showed him the cake.  Well, do you know what he did?"

I could guess easily enough.  "He finished the cake."

"Yes, he did! How did you know?"

"I just guessed.  Does Bill have diabetes?"  I asked, innocently enough.

"Oh, yes. But he doesn't follow his diet at all.  He'll eat anything, particularly if it's sweet.  He just doesn't stop."

Now I could see it all.  Kenneth was telling me this story, not to distract me from scolding him over his diet, but to pardon himself. "See," he was saying.  "I know someone who is much worse than myself.  I'm really not so bad."

This of course is human nature.  It is difficult to change our actions and so, we find people around us who are "worse" than we are and point at them.  Someone is following their diet worse than we are, or someone is exercising less than we are.  It makes us feel better about ourselves, without our really having to change a thing about ourselves.

Unfortunately, when it comes to sin, it is not enough to point to someone worse off than us. The Bible tells us "All have sinned and come short of the glory of God." (Romans 3:23)  There is no question that there are plenty of others around that are full of sin, but the question is whether we personally have made an attempt to make things right with God.  Until we are willing to do that, we will be stuck with the wages of sin -- death.

Simple Fun

Somehow this week, we were hit by another six inches of snow.  It was pretty late for such weather here, but it gave my children and me one more chance to go sledding

I've always wondered who came up with the idea of sledding.  Who decided to take a board and smooth it out and shape it, just so they could climb to the top of a high snowy hill and try slide down?

Even now, sleds are pretty ancient technology.  Other than the fact that most are now made of plastic, there isn't much that has been updated.  There are no shock absorbers, no brakes, and no safety features like seat belts or, air bags.  Not that you would really want to be strapped to one of these thin plastic toboggans anyway, in case of a wreck.

The biggest thing about them, is that they are fun.

Watching my children careening down our hill on these sleds makes me remember what fun is.  Genuine fun is simple, contagious, and shared.

I am afraid that too many in this world have forgotten that.  With all of the high tech devices out there and the complex game worlds that have been designed for them, the simplicity is gone and the shared aspect is left behind.

I would hope that for a few moments people would put away their phones, grab their kids and a sled and share a little winter joy together.  And when they are tired, come inside and drink hot chocolate together and pull out a board game and have more fun.

In the midst of this simple fun, something greater happens.  Relationships are formed, memories are made, and joy is kindled in eyes and hearts.

It doesn't really matter who was the first person to sled.  It is just important that we experience fun as a family.

Make it simple.

Make it shared.

That's what your children will remember.

Room to Grow

When I was growing up, my mother was a firm believer that you should buy clothes with "room to grow."  This meant that my clothes never fit at the beginning of the school year and sometimes not at the end of the school year, either.

At the beginning of my third grade year, my mother went out and bought me new shoes.  They were very nice, but they were big enough that they kept slipping off. 

At recess, we had a game of kick ball going.  When it was my turn, I ran up and viciously kicked the ball.  Unfortunately, my shoe traveled farther than the ball did, flying out and landing just past second base.

It was very embarrassing.

These days, I don't  buy my clothes with room to grow.  I achieved my adult height long ago and while I may get bigger around the waist, I would prefer to remain the same size.

At the same time, there are areas in my life where I hope I never stop growing -- in knowledge, in kindness, and in wisdom.  In love for God and love for those around me.

I'm afraid in a spiritual sense, it is all too easy to reach a place where we feel like we are good enough and become complacent.  There is little need for spiritual growth when you believe you have achieved everything you need to achieve.

I am afraid that there are lots of people who, having reached base camp at Mt. Everest never have a desire to climb higher.  Just being there is good enough for them.

At the same time, the giants for God did not become so overnight.  Day by day they experienced growth.  Through trials and tempests they struggled on, never complacent, never satisfied.

They were always looking for a closer walk with God and a deeper connection in prayer.

They always bought their spiritual clothes with a little room to grow.

That's how I want to live.

Surprises

I don’t like surprises. It is not astonishing, since in my business, they are almost always of a negative nature. They usually begin with a telephone call at 2 am and an apologetic, breathless nurse on the other end saying something like: “I’m sorry to bother you Dr. Waldron, but…” It all goes down hill from there.

A couple of years after I began practice, I remember one such event.

 

My patient Caesar had been in the hospital for four days and he was going to a nursing home. “Not long term.” I had assured him. He would only stay there long enough to get his strength back and then he would return to his own home.

Caesar was a cantankerous old man who had lived in the community for all of his 76 years. He experienced a small stroke and now had some residual weakness. Not a lot of weakness, but enough to keep him from going straight home.

It was two o’clock in the afternoon on my day off when I received the telephone call. The nurse on the other end was breathless. “Dr. Waldron, Mr. Campbell is not doing very well.” I grimaced internally. That statement could mean almost anything, but it was almost definitely bad. “What’s going on?” I asked.

“He’s breathing much harder and he can’t seem to catch his breath…”

I listened with half my mind, inwardly reviewing his medical problems. When the nurse finished speaking, I gave some orders. I finished by telling the nurse that I would be right in.

The nurse had been right about Caesar. He wasn’t doing very well. His breathing was labored and he was using his chest muscles to assist with every breath. As his labs and imaging results began to come back, the cause became much clearer. He had developed a pulmonary embolism.

A blood clot to the lungs in a young person is bad enough, but in a 76 year old with emphysema it is life threatening. I had the nurses call the family to come in.

Caesar’s only daughter arrived and I went over the situation with her. I asked her is she knew her father’s wishes about being ventilated. She shook her head. “I don’t think he does, but I’m not sure. Have you asked him?”

I hadn’t, so we went together to his bed. Caesar was laboring to breathe, but he was still alert. I explained the situation to him and asked if he wanted to be put on a ventilator. He shook his head no. “You understand that you will probably die if we don’t put you on the machine?” I asked.

Caesar nodded “I don’t… want… machine.” He gasped out.

I wrote orders to make him comfortable and to try to stop the clot, and then stood at the foot of his bed, feeling helpless. This wasn’t supposed to happen. Caesar was supposed to get well and go home. I had promised him as much.

Caesar’s daughter seemed to sense some of my helplessness, for she rose from her chair at Caesar’s bedside, and touched my arm. “It’s OK.” She said simply. “It’s what dad wants.”

She spoke the truth. He had not wanted a ventilator. As I stood there, I realized that I was feeling sorry, not for Caesar, but for myself. It is the nature of young physicians to believe that they can predict and control all in their patient’s lives. I felt distress for not having predicted this embolism and as I realized this, a kind of peace came to my life.

For, I learned what many physicians never learn. I learned that human life is hopelessly complex and that no one can completely understand it. I learned that the most important thing is to follow the patient’s wishes. Most of all, I learned that I am not God. Despite all of my efforts, some things cannot be controlled. There will always be surprises and that will not come as a surprise to me again.

Seeing the Light

As I was driving home from work last night, there were clouds everywhere.  The sky was a slate gray, with the sun hiding somewhere just above the western horizon.  Then, suddenly, for a brief moment the sun poked its head out, lighting up the edges of the clouds and turning the heavens all orange and pink.

As I looked at the beautiful sunset, I realized that the loveliest sunsets have clouds.  The sun sinking behind a ridge on a cloudless day is not nearly as breath taking as the sun shining through broken clouds.

It is the contrast between the clouds and the sun that lets us see and appreciate the beauty of the sun.  It is the darkness that makes us reach towards the light.  It is the sorrow of death that makes us hope for heaven.

I have found that this world is a very dark place.  There is anger and hatred.  Sadness abounds on every side.  I wonder how to explain this sort of a world to my children.

I cannot explain to them the evil that is around us.  I cannot understand it.  But it isn't important that they understand it.  It is far more important that they know that they are loved and in that love they can feel secure, whatever winds may blow.

It is in these sorts of times that I seek my Heavenly Father's face.  For, I cannot comprehend this world and its darkness.

As I stand before Him, God doesn't explain the mystery of the darkness to me.  He only shows to me His light and His love.  In that moment, I understand a little better who He is and how great His love is for me.

And that's enough.

The Road to Victory

The year was 1997.  I was the intern (first year resident) on the surgical service, taking calls from the Emergency Department and admitting patients through the night in downtown Dayton, Ohio.

It was a busy night.  Sometime, around 2 am, I got called to admit another patient for an oral surgeon we worked with.

The patient was an African American lying on a gurney, under the bright fluorescent lights of the ER.  His face was swollen and disfigured.  Every so often a faint moan escaped his lips.

From what I had been told by the ER doctor, he had been beaten up by someone using a forty ounce beer bottle (empty), when he was caught breaking into a garage.  He had several facial fractures and in the morning would get his jaw wired shut to allow healing.

At this moment, though, I had to get enough information from him to  dictate a History and Physical and get him up to the floor.

"So what brings you in tonight?"  I asked him pleasantly.  Kind of an obvious question, but at two a.m., you tend to fall back on the things your usually say.

"Mmmmph..." he told me and pointed at his face.

"OK," I said, jotting down: 'Presents with facial pain,' on a sheet of paper.  "What happened?"

"Mmmmmmmmmmmph," he said.  He could talk, but the sounds weren't clear enough for me to catch distinct words.

I tried again.  Again, I couldn't understand what he was saying.  At this point, an older nurse who was flushing an IV line looked over at me.  "He says he guesses he was in the wrong place at the wrong time."

I suppose he was right, although put that way, it sounds more like missing a bus, or a connecting flight, than breaking and entering.

Over the years, I have taken care of many people who I have 'caught' in wrong doing.  Most often, it is with them using street drugs.

Unfortunately, most, when they are confronted, try to minimize their problem or excuse it.  They don't really have a problem. 

And what I want to hear them say is:  "Dr. Waldron, I am struggling.  I am not in control.  I need your help."

That is definitely what God wants to hear from us.

Jesus told the Pharisees that he had come to heal the sick, because the well didn't need a physician.  It wasn't that the Pharisees didn't need help -- they needed healing just as much as everyone else in the crowd -- it was that they didn't think they needed help.

It is only those who do not believe they need help who are truly beyond help.

As we confess our sins and our weaknesses and seek the help of others, we can and will gain victory.  It may seem easier to deny wrong doing, but the road to victory begins with an honest confession.

The Very Best Question

Photography has many things about it that are important.  Light, subject, and composition all can make an image work, but focus is something very simple that if not present can make a good photo worthless.  Occasionally, the issue is that nothing is in focus.  More often though, the problem is that the focus is on the wrong thing.

Imagine a photo of a bride and groom standing in front of some pretty average trees.  The only problem is that couple is fuzzy and the landscaping is sharp as a tack.  You can even see a situation where the buttons on a man's shirt are nicely focused, but his face is kind of soft.

In life, it is even more important what is in focus.  We just can't focus on everything.  Dark clouds versus silver linings is the most obvious situation that comes to mind.  To focus on the darkness leaves me melancholic of spirit, while there generally is something good in every situation, if I just look hard enough.

Even more important is to focus on what God wants me to learn from a given situation.  This is difficulty.  Last summer, we vacationed in Chattanooga.  We were getting ready to leave the cottage where we were staying to go see the Tennessee Aquarium when I gunned the engine (not realizing I was in reverse) and backed up into the cottage, really messing up the back end of our mini van.

For the next several hours, I couldn't see anything except how I had messed up our vacation.  Darkness and distress just pounded my heart and mind.

Because, it was just a stupid thing on my part -- an accident.  I spent the next little while calling to find a body shop to repair the van and praying -- trying to discern what God wanted me to learn from this accident.

Maybe all I needed to learn from this situation was to pay attention better -- particularly to whether or not I am in drive or, reverse.  Or, maybe God wanted me to trust Him more, or listen to my wife better, or yield my fears to Him.  Or, maybe it is all of those things.

If I am honest, I can grow in all of these things -- a lot.  Just because I finished medical school eighteen years ago doesn't mean it is time for me to stop learning.

God is a teacher and He plans the lessons that I need.  So much better if I learn what He desires from them the first time.

This is the most important question to ask in every situation.  Not, "What Would Jesus Do?"  Although that is a fine question, but "What would God have me to learn?"  For, if I don't learn that lesson, I am bound to repeat it.  I can't move on, until I have completed this lesson.

This would be my focus, even in the darkest moments of life.  To learn the things God has for me to learn, even when the lessons are hard.  In this way and this way alone I can truly grow to be like Christ.

Measles

Measles is in the news right now.  An outbreak has hit California and dozens of people have gotten sick with it -- some sick enough to require hospitalization.

Into this fray have ridden pro and anti-vaccine advocates, explaining why vaccines would or wouldn't have helped prevent this outbreak.  I read a recent blog post by a Christian doctor detailing a story of a child under his care who died of measles and I have read other stories of children who have suffered terribly after vaccines.  I believe that all of these people are being honest, but there are other things to remember.

Temporality does not equal causality.

This is the sort of thing that leads to superstition.  A black cat walks across my path and then later in the day I have a bad accident.  Did it have anything to do with the cat?  Just because one event comes before another doesn't mean it caused the later event.

In the medical world it seems to be tougher to analyze the situation.  If I started coughing two days after I got a flu shot it is easy for me to believe that the flu shot gave me a cold.  But, maybe someone at Walmart coughed on me or, maybe I shook hands with someone who had a cold.  Most of the time when I get sick, I never know who was the generous soul who shared with me -- maybe a patient, maybe someone at church.  Identifying the cause is not as easy as remembering what happened right before I got sick.

Anecdotes are both the weakest and the strongest type of evidence.

People tell stories -- hopefully true stories -- about vaccines and plenty of other things in their life.  In many ways, these stories influence us the most because they hit home.  We can picture in our minds the sick child dying of measles or, the paralyzed nonverbal child, suffering because of an unneeded vaccine and our hearts melt in sympathy or, shake in anger.  And yet, these stories tell me nothing about the overall risks of a vaccine or the illness it is intended to fight.

Much more useful are statistics.  If I know that twenty-five percent of those who caught measles in the Disneyland measles out break have required hospitalization or, that the rate of serious complications with the MMR vaccine is 4 per 10,000 children vaccinated (mostly fever fits), although ten percent of children get fevers and joint aches after the shot, then I can compare risks and benefits of the vaccine and the illness.

Everything has risks and benefits.

If your doctor diagnoses you as having carotid artery blockages (narrowing in the arteries in your neck), he will send you to a surgeon who will then tell you that the risk of no surgery is a 20 percent chance of stroke over the next two years, while your risk of having surgery done is 2.5 percent chance of stroke or, infection.  I think in this setting, most people would elect to proceed with surgery, even understanding that there is a significant risk to the surgery.

In the same way, everything we do (or don't do) has a risk.  Taking any vitamin, supplement or, antibiotic contains within it a possibility of reaction to some ingredient in it.

The problem is that for the most part the risks of the activities we do every day are unknown.

With vaccines, they are clear and are published in numerous scientific papers for those who choose to know.

Choose wisely who you believe.

Everyone thinks they are an expert.  Unfortunately, in the internet age, everyone's voice is the same volume (usually shouting).  It is more important to have good data backing up opinions than to be an "expert" in the field.

The tendency is to look for views that mirror our own and to collect those, rather than investigating all possibilities.

Vaccination protects others.

There are plenty of people who cannot get vaccinated.  They have cancer and are receiving chemotherapy, or are immunosuppressed, or have a history of a serious reaction to a vaccine, or an allergy to the vaccine.  The way to protect them is to be certain that they don't get exposed to these illnesses. 

I believe the loving thing to protect these unvaccinated children and adults is to do my best to make sure that neither my children or me will be the vehicle by which they get exposed to a preventable illness.  There may be some risk to my children, but it is worth it.  My children have decent immune systems, they would probably do OK with many of these illnesses, but there are plenty of folks around who wouldn't.

Vaccines protect the "least of these" even more than they protect the strong in our society.

Distance makes the heart grow fonder.

The fact that most of us in the United States have never seen any of these once common illnesses makes us think that they were no big deal.  Yet, every one of these illnesses has a rate of serious complications.  Unfortunately, for viral infections like Measles, German Measles, and Mumps, there are no treatments, only supportive care.  A certain number of the cases, even in a developed country like the United States, will lead to long term problems like neurologic symptoms or, sterility.

Honestly, it isn't just the risk of serious illness that leads me to vaccinate my children, although those risks are real for unvaccinated children.  Even if my children didn't get seriously ill, the idea that they would have multiple week long illnesses throughout their childhood, during which they were miserable and I could do little to help them is something I would rather not experience.

In the end, I am sure I can do nothing to change the minds of those who are convinced that some vaccine company has paid me under the table, or brain washed me into mindless belief in vaccines.  I have looked at the statistics and they aren't even close.  The risks of vaccines (which are real) are far out weighed by the morbidity of these diseases.

That's why I recommend vaccinations.

That's why I vaccinate my children.

Making Supper

"Mom, I want to make supper tomorrow night!"  Anna announced. 

That was how it began.

After poring over cookbooks for a little while, with her mother helping her, Anna decided she would make a dish called Chicken Etti (at least that's what I think it is called), with Lima Beans on the side and followed by chocolate pudding.  A feast fit for a doctor and his wife, if I may say so.

Tuesday evening she was really excited as she put the pieces of chicken and the rice in a nine by sixteen pan, covered it with aluminum foil and put it in the oven.  Then she carefully beat up the chocolate pudding.

Then, she set the table, carefully choosing the right cups and plates for each person.

An hour and a half later, Elaine opened the oven door and took the pan out.  Anna was almost dancing with delight as Elaine lifted the covering from the top of the dish.

"Oh dear," Elaine said.  "It isn't done."

The chicken was still raw.  It turned out that the bottom coil on our oven had burned out.  The top was still working, but not giving out enough heat to cook the chicken -- at least not in an hour and a half.

"It's all spoiled!"  Anna wailed with tears in her eyes.

It is awfully easy to get discouraged when you work hard to try to do something good and then it just doesn't work out.  Galatians 6:9 says "And let us not grow weary of doing good, for in due season we will reap, if we don't give up."

So many times we spend time and give effort, only to have our actions flop, or be misinterpreted, or just not work out.  It is easy to think that it just isn't worth it to try to do good things in this world.

But it is.

Someday, we will reap the seed we have sown.  Far better that that seed should be full of good things than that it is the result of a self-centered life that does little good for anyone else.

Coconut Black Walnut Pound Cake

Elaine made a Coconut Black Walnut Pound Cake yesterday.  It was really good.  Maybe not so good if you don't like black walnuts, or coconut, but I thought it was phenomenal.

As I ate my first piece, I thought of all the time put into it.  Elaine spent quite a bit of time preparing and baking it, but before that, I had spent many minutes picking up black walnuts, peeling the hulls of them, and then cracking them.  I can't imagine that there is less than two hours of my time invested in this cake, making it (I suppose) one of the most expensive cakes I've ever eaten.

I don't really know why I spent so much time working with these bitter, meaty nuts -- maybe just because they were there.  Maybe because they were a challenge for me.  What a strange ingredient black walnuts are.  They aren't sweet, in fact, I think they taste kind of bitter and yet they taste really good in sweet things like fudge or, brownies or, pound cake. 

It is tempting to think that a life that is all sweet things would be perfect, but the reality is far from that.  It is difficult times, times filled with deep emotion, and moments of sorrow that draw us closer to God and help us to grow.  And God knows this and so His recipe for our lives includes not just sugar and spice and everything nice, but also sour and bitter things like black walnuts and rhubarb and coffee.

That is just what we need.

A recipe that is all sugar would be awful to eat and while a Coconut Pound Cake would be good, a Coconut Black Walnut Pound Cake is far better.

The Wrong Road!

"Dad, I don't see anything in front of us!"  Elliot said in a very concerned voice.

I looked over my shoulder to where my 3 year old son was residing in his car seat.  "It's a good thing there isn't anything in front of us, or we'd run into it," I said.

There was silence for a little while, maybe ten seconds, then Elliot piped up again:  "Dad, I don't think this is the right way to go.  Actually...  I think this is the wrong road!"

We were driving on country roads in Virginia, going to visit Elaine's uncle David.  "Elliot," I said.  "You don't even remember going to Virginia before.  You've never been to Uncle David's house.  How would you know?"

"I don't want to be on the wrong road!"  He wailed.

Hard to believe that a three year old could get worked up, particularly about directions, but he sure could.  Furthermore, Elliot was no GPS.  The roads he thought were the wrong roads were inevitably the right way to go.

As I look at this coming year, it is fresh and untravelled.  The paths within it are unknown to me.

I don't know what the future holds or, everything the next year holds, but I would rely on my God to choose the right paths for me to take.  For, He is trustworthy and far better than a GPS unit at getting me where I need to be -- at the right times, in the right way.