Reality or something like it - A Sermon

A Sermon from February 11, 2006 - delivered at Kendu Bay Adventist Hospital Church, Kenya

Have you ever considered reality? What is it? When you are in bed with the mosquito net down around you and you look out that is your current reality. When you lift the net and look out the reality changes just a bit and that becomes your current reality. Which is more real?

You and several friends are in Kisii walking along a street when all of a sudden a matatu and another car collide. What you witness is your reality. Each one of your friends, while seeing the same event has a different perspective of that event – a different reality.

We were speeding along, while on Safari in the Masai Mara, when all of a sudden our driver stopped. The reality I saw was just more of the same savannah. However, our driver had a different reality: he saw they way the animals were moving and looking and within a few seconds of stopping he pointed to a stand of trees, across a river, about a half mile away: “There, do you see it? A male lion.” I had to take out the video camera and zoom in to see it. All it took was openness to a larger reality than my own to see so much more.

Repeat after me:

“I can live the life God has called me to live, in all dimensions—work, family, relationships, community, and the larger world.”

Do you believe it? How do you feel when you say it?

Most people have an automatic reaction to that statement. They either believe that they are powerless or even if they had the power to make it happen that they are unworthy to have such a life. And some people believe that they are both powerless AND unworthy.

In God’s reality nothing is further from the truth. Instead we have been enslaved to a way of thinking and acting that reinforce the feelings and beliefs of powerlessness and unworthiness. We are slaves of our beliefs. This is our current reality.

God has the big picture. Thus the truest reality is found in God. We see ourselves as powerless and unworthy, God sees our true potential and the reality of that potential in action. There are dozens of times in the Bible we are told to “change the way we think and act.” There is evidence that many of the flawed Bible characters did just that.

Able, Enoch, Noah, Abraham, Isaac, Jacob, Joseph, Moses and his parents, Rahab, Gideon, Barak, Samson, Jephtha, David, Samuel, and all the prophets have three things in common: 1) God called them; 2) They believed; 3) They committed themselves to action.

These people of Hebrews 11 were called to some pretty BIG things. Most of us are not called in that way.

I first heard God calling me to trust him as a four year-old and into my teenage years. As I graduated from University I followed God’s calling to work in the Hollywood film and television industry. Six years later he called me to leave Hollywood for a nonprofit religious group. He has called me to the career I have.

I have also been called to a long and satisfying marriage.

I have been called to deep and personal friendships. 

I have been called to offer my best to my wife, my family, my job, my friends, my community and the world at large.

I have been called to live a balanced life.

I have been called to a deep and personal relationship with God.

I have been called to live the life of the Spirit and reap the fruits of the Spirit.

I have been called to many things, this I know. 

I also know that I don’t always feel up to the task.

I am not alone.

“This law I have found at work… that which I want to do I don’t do, and that which I don’t want to do I do… (Romans 7)

Who will save me from this? Thanks be to Jesus.” 

“The truth will set you free.”

Who is “the truth”?

Jesus

Proverbs 8:

Wisdom calls out:

Who is wisdom?

Jesus

John 15 tells us Jesus has called us to friendship; and that he has chosen us to produce fruit that will last.

2^nd Thessalonians chapter 2 tells us that “in the beginning he chose us to be saved through a life of spiritual devotion and faith in the truth.”

And this one from 1^st Peter chapter 1 “God the Father knew you long ago and chose you to live holy lives with the Spirit’s help…”

1 Corinthians 1: 27 and onward:

“God chose what the world considers nonsense to put wise people to shame. God chose what the world considers weak to put what is strong to shame. 28 God chose what the world considers ordinary and what it despises-what it considers to be nothing- in order to destroy what it considers something.

Have you considered the difference of “choosing” and “wanting”? 

[review these verses using and comparing choosing and wanting]

In his book "The Fifth Discipline" Peter Senge says this: "For most people, 'I want' is passive; 'I choose' is active... wanting is a state of deficiency - we want what we do not have. Choosing is a state of sufficiency- electing to have what we truly want." (p360) 

[examples from my life: Trixy; Work; play; etc]

God also, has said “choose” and “chosen” rather than “want”

1 Corinthians 1:9

“God faithfully keeps his promises. He called you to be partners with his son Jesus Christ our Lord.”

So I can readily admit that I do not always feel up to the task. But I can choose to believe. This helps me create a vision for myself of what I will become. It helps me accept God’s design for my life.:

I believe God has called me and chosen me.

I believe God to be true to his word.

I believe I have been empowered to continually grow towards my calling.

I believe I have been made worthy to achieve my calling.

I believe that one person can make a difference.

“I can do all things through Christ who strengthens me.” Reminding me that I am not powerless.

“I have come that they might have life more abundantly” John 10:10 reminding me that God considers me worthy.

And this one found in Mark 9: 23 and 24

Jesus said to him, “As far as possibilities go, everything is possible for the person who believes.” And the child’s father cried out at one, “I believe! Help my lack of faith.” And this reminds me that I can believe today and that my belief today is small to the belief that is coming.

In following our calling and believing is acting. We can still choose to ignore our calling and we may chose to never truly believe. However, If we choose to accept our callings and we choose to believe what God has promised, then action will follow. 

This is also not easy. Since “wanting” is passive and “choosing” is active, we can see that acting on our calling and belief involves our choosing. But choosing isn’t enough on its own. We need also commitment. Choosing declares our action and direction. Commitment keeps us moving towards our choices even when the going gets difficult and discouraging. I could go on for hours about choice and commitment, but let me just summarize for today: We need to be committed to:

truth

growth

and finally to “seeing it through”

“Imitate me as I imitate Christ.”

Jesus is called to reconcile the universe to himself

Jesus is committed to truth

Jesus is committed to restoring freedom and choice

I haven’t even begun to discuss “freedom”. But one thing I council is this: “Just because you can doesn’t mean you should.” Christ has set us free. Free we are. Free to enslave ourselves again. But God hasn’t called us to slavery, but to true freedom.

What binds this all together is “Love”. True freedom is described in 1 Corinthians chapter 13 and in Galatians chapter 5. Love which isn’t sentimental, but committed and unconditional.

“If we let Him—for we can prevent him, if we choose—He will make the feeblest and filthiest of us into a god or goddess, a dazzling, radiant, immortal creature, pulsating all through with such energy and joy and wisdom and love as we cannot now imagine, a bright stainless mirror which reflects back to God perfectly (through, of course on a smaller scale) His own boundless power and delight and goodness. The process will be long and in parts very painful, but that is what we are in for. Nothing less. He meant what He said.” CS Lewis

So in my own example:

I choose to follow God’s calling.

I choose to have a long and satisfying marriage.

I choose to have deep and personal friendships.

I choose to offer my best to my wife, my family, my job, my friends, my community and the world at large.

I choose to live a balanced life.

I choose a deep and personal relationship with God

I choose to pursue truth about myself—about my thoughts and actions

I choose to limit my freedom in order to achieve my calling.

Today, I am your safari driver. I say to you today “Do you see it, across the river and by the tree of life? It looks so far away, but it isn’t. There by the tree is the Lion of Judah. And he is calling you.” You are not powerless or unworthy to answer his call.

What is your calling?

To what are you committed?

What do you believe?

And what will you choose?

“May God who began the good work in you see it through to completion…”

2 Thess 3:3-5 paraphrased

The Lord is faithful, he will establish you and keep you from evil. And I have confidence in the Lord touching you, that you both do and will do the things that are necessary to let go of what holds you back from your calling. 

May the Lord direct your hearts into the lover of God, and into patient waiting for Christ.

This is my prayer for you today.

Thoughts on Life

November 9, 2001.

I've been reading over "Wild at Heart" in preparation for my weekly meeting with Elwyn. We are on Chapter 11 of 12. The title is "An adventure to Live". I've long looked at life as a grand story revealing itself over time. I've often wondered what stories others are living. What have they seen? What are their experiences? How do they see life?

Life for me is an adventure and this book feeds my thoughts. A key question of course is "What is adventure?" Let me put out that adventure involves the unknown (mystery perhaps) and thus, risk. The "unknown and risk" imply a lack of controllability, a lack of formulaic procedures to solve problems. The "unknown and risk" imply danger and creativity...

God created the universe, he created the creatures in heaven and on earth. Thus he created Lucifer, Adam, and Eve. His creation was perfect and free. His creativity provided mystery and risk. God did not provide a step by step plan to his creation. He provided relationship with himself. That relationship with him is as unique as each individual.

What are important areas of our lives? God? Spouse (significant other)? Close friends? Work? Do any of these seem routine? Are there unknowns? Do you know God so well that there is no more mystery? What about your spouse? Do your friends surprise you from time to time with what they think or do? Is work exactly the same day to day? Are there unknowns out of your control? What are the risks? What spiritual battles do you face? Do you deal with them the same way every time? What if God offers you a different solution? You have friends. Did you follow a formula to get to know them? Which of your friends excite or inspire you? Why do you think this might be? Have you ever felt truely alive? What was your experience? What was it that brought you to the state of being alive?

I'm still answering these for myself. But I am coming beginning to accept that God and formulaic solutions don't mix. What works for one might not work for another; that God sees unique solutions for his unique creatures, all the while bringing them to the same final solution...relationship with him. This relationship, in its truest form, is not passive. No, its quite active indeed. He is active with us and we are active with him. Our lives change the closer we get to him. If we no longer see mystery, the unknown, or realize the risk of any of our relationships, then we've stopped looking and are trying to control. Seek the danger of discovery, run the risk of finding out what really is?

"Never make a principle out of your experience; let God be as original with other people as he is with you." Oswald Chambers

"I want to love with much more abandon and stop waiting for others to love me first. I want to hurl myself into a creative work worthy of God. I want to charge the fields at Banockburn, follow Peter as he followed Christ out onto the sea, pray from my heart's true desire." John Eldredge, "Wild at Heart" p 199

"I no longer call you servants...Instead, I have called you friends." Jesus "John 15:15"

What does it mean to be friends with God? Adam, Enoch, Moses, Abraham, all the men and women of faith from Hebrews were friends with God. Take a look at their individual relationships with their Creator...

Happy Sabbath, God's blessing to you and yours

Bill

The Choice to Serve Life

So I wrote this as I began my PhD, a few too many years ago. But as I can't find it published anywhere I thought I would share it now. 

**

Where servant leadership can sometimes suggest ONLY serving those you wish to lead, "serving life" serves everything.  What I find I need to do is explore the meaning and value of "choice" and "service".

For now I will focus on service.  Is service "Whatever you say I will do?"  Is that a good servant leader?  No.  While that is exercising one's choice, I think that method is very limiting in the "big picture".  A CEO who says to his company "whatever you say I will do" will soon realize someone else is leader.  But maybe that is where the PEOPLE are.  And they say, "whatever you say we will do."  Again, I find that will be limited as a mode of service.

To offer the best of one's service had come to mean knowing somethings about one's "self".  Who am I?  What are my strengths?  What do I believe?  What are my weaknesses?  What are my boundaries (can I do that which I believe to be wrong)?

Service and being a servant then do not suggest to me "doing whatever the people I am serving want".  Choosing to be a servant is a choice to serve from my best, from who I am.  While I have found the core of who I am to be fairly stable, the expression of that and many of the details have changed overtime.  Thus I conclude that who I know myself to be evolves over time.

"Life" on first look is "easy".  EVERY thing on this earth is life.  Every thing in the universe is life.  While that seems easy to me to say, the difficult part is uniting my being "a servant of life".  Life is me and all I am am.  It is my wife Trixy and all she is.  It is our dog Jordan.  It is our yard and all that creeps and crawls in it.  Life is our neighborhood and town and all the people and things in it.  Life includes the wilderness areas, cities, crime and goodness.  Life is healthy and unhealthy.  Life includes the bonds that unite people together.  Life includes the wedges that divide people.  Life includes belief systems of all sorts: those who believe in some form of God and those who do not.  Life is "the big picture" and everything in it.

The choice to serve life:  I must serve myself.  I must learn to love who I am while not being selfish  complacent.  I have growth to do.  I must serve my wife.  I must learn to love who she is, encourage her to love herself, yet not be complacent (MUCH harder to do).   I extend this to my friends; coworkers; bosses; employees.  Every time "love" must be present.  I MUST learn to love people I don't like.  But how do I show "love" to my neighborhood, town, wilderness areas, people I have never met?  My mind sometimes just spins at the thought of it.   

As I reflect, the choice to serve life is the choice to serve the big picture.  I need not try to love those I don't know and haven't met and may never meet.  By my serving life where I am, in what I do, in my attitudes, in my communications, I WILL serve those I don't know and haven't met.  

Some illustrations come to mind:  

A child who is learning to walk.  S/he takes a step or two and falls down.  Do we focus on the fall? or do we focus on the next step?  I believe serving life focuses on the next step.

Learning to ride a bicycle (walk a balance beam etc), do I focus on my feet?  Do I obsess with my shakiness?  or do I look forward?

There is a country where if you injure someone you must pay their hospital expenses, but if you accidentally kill them you pay the family $300.  Or where the penalty for killing a cow is more severe than for murdering a person.  The choice to serve life must examine these for the big picture.  

When I think on these things I realize that the choice to serve life is not limited to Christian, or others who profess belief in God.   The choice to serve life is for anyone, just as any one in any belief system might NOT be serving life.

But I will close my thoughts with this:  My belief system suggests that anyone serving life from the root of "Love" (unselfish, unconditional, agape), is serving God, regardless of any identity, culture,  race, creed, or religion.  My faith system indicates that only God's true children love as God loves.  The God I worship and admire loves his entire creation and is the ultimate example of the choice to serve life. And therefore isn't limited to the box of my personal beliefs or faith tradition.

The Mundane Into The Glorious

Author’s Note:

I want to express my sincerest gratitude to those of you who read along with my blog stories and musings. I am often encouraged by the replies that I receive. Your comments serve to reinforce and further bless me in my own spiritual convictions.

Emily has been kind enough to allow me to share an excerpt from an email with me relating how our day-to-day humble service is important. The work that we might be tempted to consider dull or inconsequential or trivial is sacred

(*As usual: names, locations, identifying data have been altered)

Email Excerpt:

“Our small, insignificant mundane acts can still be sacred acts to God. Perhaps?"

Yes - definitely!

After my youngest started school, I was feeling a bit useless. I remember, after perhaps drinking a bit too much wine at home one time, bemoaning that I felt like a "waste of space".  I was missing the status of having a career and being needed 24/7 by small children. I didn't know what to do next with my life now that I was no longer “needed”.

Finally I got a job doing the bookkeeping in a little office next to a small joiners workshop with the wood dust and loud machines and loud blokes hollering and swearing. It felt like a big step down from what I was used to do, but the hours were convenient so I took the job, working for a lovely lady called Helen (*). The record books were in a terrible mess at the workshop. Helen hadn't balanced the bank accounts in over a year and I wondered how she could continue to operate. I slowly starting unpicking the figures and bringing things up to date.

So I worked at the joiners two days a week and spent the rest of the time helping my friend Miriam dig her garden allotment and chatting to my neighbour, Sandra, over her fence.

One week I sat in church and asked God what I was supposed to be doing. I asked Him what He saw in me and what was my purpose in life. The vicar was talking, but I wasn't really listening. I just stared at the pale figure of Christ in the stained glass.

Suddenly a question popped up. "Can you be a servant?" The question seemed to come from the stained-glass window I was staring at.

"But I don't want to be a servant,” I replied, without thinking it was just a little strange to be having a conversation with a stained glass window.

Then I remembered the words in the Methodist Covenant Prayer: Let me be employed for thee or laid aside for thee, exalted for thee or brought low for thee.

As I sat staring at the figure of Christ in the stained glass, I began to realise that the reason Helen hadn't been looking after the bank accounts for her workshop was that she was so busy attending to the needs of a sickly friend. Helen was unable to manage the accounts because she was spending her time, instead, taking her friend with cancer to chemotherapy appointments and looking after her friend’s children.  But now Helen had a bookkeeper (me). Now she could continue to care for her cancer friend without worrying over her business affairs. My humble tallying of mathematical figures in the joiner’s business accounts was a worthy occupation and was necessary for the smooth running of the business but also blessed others in ways I did not initially realise. Helen had peace of mind and her sick cancer friend benefited through my careful booking efforts as well. My “insignificant” efforts in balancing the business books blessed others in ways I never imagined.

As I let that first realisation sink into my consciousness, a second awareness dawned. Miriam, the neighbour that I helped dig in her garden, actually spent those long hours cultivating her allotment because it took her mind off a series of miscarriages. I couldn't fix these, but I could relate, and I could sit out in the sun and the rain with her while she grieved. To ‘weep with those who weep’ was an act of love that was within my capacity to give Miriam.

And then, as I continued to sit in church and absorb the full impact of this second act, a third thought struck me. (It was becoming a very fruitful ‘conversation’ with a stained-glass window).  I realised that the reason Sandra sat out in her garden by her fence, hour after hour, was that she was lonely. Her husband had recently died leaving her all alone but she was reluctant to go and knock on anyone's door for fear of being an "imposition". Instead she sat outside by her fence, hoping for someone to come by and talk with her. I couldn't fix the death of Sandra’s husband but I could listen and chat with her.

So, there I was in church, still staring at the pale figure of Christ in the glass window without listening to the Vicar’s message but hearing a message from God nonetheless. I’d been thinking about Solomon in the Bible when he built the temple mentioned in Chronicles. It took thirteen years with the craftsman having to make all sorts of paraphernalia out of wood and metal. Their work must have been quite boring and tedious, detailed workmanship to create such intricate temple ornaments according to the tight specifications. (In fact, just reading the story in Chronicles is rather mind numbing and a good treatment for insomnia!) Perhaps the craftsmen as they carved out yet another silver embellishment wondered why they were doing it; but, God honoured their work. When all was finished, His glory descended upon the temple and it was, well, glorious. So, too, God was being honoured by my own faithfulness to the small acts of day-to-day service opportunities. I was like the craftsmen in Chronicles with my attention to the details of my accounting, my digging, and my chatting. They were important sacred acts of loving service to God. The mundane made glorious in Christ.

“That our sanctification did not depend upon changing our works, but in doing that for GOD’s sake, which we commonly do for our own. …That the most excellent method he had found of going to GOD, was that of doing our common business without any view of pleasing men, and (as far as we are capable) purely for the love of GOD.”

― Brother Lawrence, The Practice of the Presence of God

The Elusive Magical Fairy Wand

“Reputation is what others think of us; character is what God knows of us.”

― Shannon L. Alder

Let’s face it, if medical professionals depended on the fickle fancies of their client-patients’ enthusiastic affirmations of ‘job well done’, we’d be in trouble.

Even theoretically, few would claim it’s possible to satisfy every customer, every time. People are fallible human beings with wishy-washy whims. Most of the time we don’t even know what we want. In an age of instant gratification with expectations of continual entertainment, it’s simply not possible to meet the standards. Healthy, happy people are often disappointed. How much more difficult it is to satisfy sick clients in mental and physical pain?

Perhaps if doctors had magical wands that they could wave in a graceful arc with cascading, twinkling fairy-dust floating down over the sick patient and instantly erasing all illness…  Unfortunately, I haven’t come across such a wand. However, if anyone does, please let me know!

So, it is not easy working with people who are suffering every day. I like to see people smile. I like to cheer people up. Generally speaking, I chose a profession in medicine because I wanted to make a positive difference in the world. Without my magical fairy wand though, I seem to encounter an awful lot of disgruntled, unhappy sick people.

Madam X sat across from me with a frown and crossed her arms. “Doctor, I’m sure there’s something wrong. I’ve gained 10 pounds and I haven’t changed anything in my life. I’ve never been this heavy before. I do the same things. I haven’t changed my diet. There’s something wrong with my thyroid.”

I glanced at her recent blood work on the computer and tilted the screen for her to view the results. “Your thyroid test was normal last month,” I reassured.

“That test isn’t always accurate though, doctor. I know there are other tests to check my thyroid that are better.” Madam X leaned back and stared defiantly at the normal lab results.

“Umm, this blood test for thyroid problems is very accurate.”

“I had a friend who’s test was normal but then her doctor ordered some other thyroid testing and they found out she had low hormone levels.” Madam X scowled. “Doctor, there is something wrong. This weight is not normal for me.”

“All your recent blood work is normal. Sometimes as we get older, our metabolism slows down a bit and it’s easier to put on weight. Diet and exercise are still the best ways to control weight and stay healthy.”

Mrs X shifted in her chair. She was clearly not convinced. “Doctor, there’s something wrong in my body that is making me gain weight.”

I shrugged. “I’m sorry. I know it’s not easy. We can talk about some ways to improve your diet and increase your activity. There are classes and groups you can join. I can suggest some local gyms.”

“No, I’m not interested,” Madam X replied. Her tone was increasingly becoming more frustrated with the way things were going. “I know how to eat and I already walk enough at work. There’s something else wrong inside my body. You’re just not willing to order the right tests.”

She left angry and frustrated. “I’m just going to have to find help elsewhere,” she gave me a pointed glare as she packed up her purse and put on her coat.

Clearly, not a happy customer.

Madam Y dangled her legs at the end of the exam bed while she fidgeted with the elaborate beaded necklace that hung round her neck. “What a beautiful necklace,” I exclaimed as I shifted our consult from the initial verbal history of the problem to the physical exam portion. Her earrings were beaded in a matching pattern with her necklace.

“Thank you, doctor,” she turned her head for me to examine the opposite ear. “My daughter makes them.”

“You have a talented daughter, very artistic,” I added.

She nodded in agreement while I listened to her heart.

“Does it pain anywhere where I press?” I asked while I palpated her abdomen to ascertain spleen and liver size.

“Right there,” she indicated as I put pressure over the lower portion of her stomach, below her umbilicus.

“Oh?” I hadn’t expected a positive to my query, having already gone through a review of problems:  high blood pressure, migraines, and sinus allergies. I felt my pulse do a double skip. Pain in the stomach can be a bottomless pit of inquiry (pun intended). A million different things can cause stomach complaints, everything from benign indigestion to life-threatening colon cancer.

“Yes, doctor, sometimes I get this annoying pain, not really painful but, well, sort of uncomfortable down where you were pressing.” She sat up as I finished poking around on her belly, having ensured there were no big masses or obvious fibroids.

I waited for her to continue.

She shrugged with a noncommittal smile. “It’s probably nothing, doctor, but I just worry, you know. It’s nothing new. Just every now and then. I keep forgetting to mention it to the doctor when I have my appointments.”

I nodded.

“Probably has more to do with when I eat too much or have too many sweets.” She folded her hands and gave an embarrassed laugh. “I know it’s not good for me but when I go out to eat. I always have dessert.”

I went throw my list of ‘red flags’ -- danger symptoms that could indicate a patient has some perilous medical condition potentially going on in their bowels. Madam Y thankfully didn’t have any of them.

“I can’t find anything on the exam or in the symptoms that you’re having that indicate we need to do more testing. From what you’re telling me, there are no signs that anything like a nasty cancer is causing the stomach pains.” I mentally reviewed my internal checklist and again came up negative for anything concerning. “You might want to keep a symptom diary and jot down when the pains come and see if there are any particular situations or foods or patterns to the pain.”

She was quiet.

I waited for her to disagree with my predictions and recommendations.

Madam Y looked down at her slightly protruding abdominal fat roll. With a wry grin she let out a sigh. “You’re right, doctor, I really just need to eat better. I eat too much. I don’t like the added weight. I’ve sort of ignored it but I know I should be more active at the gym and cut down on my calories.”

“Choosing more healthy foods and getting more exercise is always a good idea,” I encouraged Madam Y with her inner health resolutions. “Exercise is the best medicine. It’s the closest thing there is to a panacea. It’ll help the weight and your blood pressure and reduce your risk of diabetes later on in life. Exercise is good for digestion too. I bet it will reduce the stomach pains.”

Madam Y nodded resolutely. “You’re right.”

I have never considered myself to be a great cheerleader. No pom-poms or fireworks. I smiled and nodded my affirmation then closed out her visit and went to print off her the summary. As I rose to exit she suddenly stood up. “Oh, doctor,” she exclaimed with a huge smile, “thank you so much. I just love you!” She rushed over and enveloped me in an unexpected hug.

My eyebrows nearly jumped off my face in surprise! (Thankfully, they are still attached. I checked afterward.) To say I was shocked is an understatement. I was certainly caught off guard. Not the reaction I was expecting. I’m not complaining either, mind you.

“You’re welcome,” I stammered back in response as she released her hold of me.  

Clearly, she was a happy customer.

Happy and satisfied versus frustrated and angry. I really can’t take credit for either reaction. There are too many other variables within a person’s life that affect the outcome in our clinic visits.

Madam X and Madam Y, with their contrasting attitudes, are a reminder that satisfaction comes from within. It’s a mind-set that we choose. I cannot look to customer satisfaction surveys or patients’ words of affirmation. Medicine is fraught with sickness, suffering, and people with emotional and physical pain. The courage to carry on in the midst of it all comes from outside my work.

I work for Christ, and, well, He’s already given me His stamp of approval.

1 Peter 4:11

Do you have the gift of speaking? Then speak as though God himself were speaking through you. Do you have the gift of helping others? Do it with all the strength and energy that God supplies. Then everything you do will bring glory to God through Jesus Christ. All glory and power to him forever and ever! Amen

Broken

It's not always easy to love others with the same love that Christ gives to me.

Broken  People

I’ve been back in the States and practising medicine in a traditional primary care outpatient clinic now for three months. One of the most common questions that I am asked, “What’s it like being a doctor in America again?”

Good question.

Complicated answer.

I’m not sure my language skills can quite express the every-changing kaleidoscope of reactions that whirl through my brain each day. There’s a lot I like about working in the U.S. again; there are other aspects I quite dislike.

One of the biggest challenges has been to find the assurance that my work as a primary care physician in an affluent society is worthwhile.

“I’m still searching for meaning in my job,” I reply to my colleague who asks me how it’s going over a lunch meeting.

He nods and listens as I continue.

“When I read about my colleagues that are still in Africa; read their blog stories; or exchange internet messages about the frustrations and difficulties of practising in resource-poor setting like Cameroon, Chad, or Malawi, waves of nostalgia and inadequacy wash over me.  I’m no longer the leader of the team. I’m no longer seeing 30 or 40 outpatients in a day PLUS managing a hospital and labour and delivery service. I feel so tiny when I think about the small number of people I see in clinic now and the minor ailments I attend to during the day.”

“For example, I saw a patient with insomnia and restless legs at night that had elevated blood pressure today. Compare that to a typical patient in Cameroon with severe anaemia and malaria that’s underweight with HIV and tuberculosis.”

“Give me some patients who are really sick,” I’ve said more than once in the past couple months.

At night I pray, “Lord, please help me not compare. Help me with my pride that tries to boost my inner ego by comparing herself to others and then gets discouraged when she perceives others are better and doing more important tasks.”

All around the world physicians are fighting against illness. Spiritual sickness. Emotional turmoil. Physical ailments. Mental distress. There is no comparison. Missionary doctors in Africa are under certain stressors like limited diagnostics, untrained staff, and organisational politics. Missionary doctors in America are under another set of stressors with paperwork, legal issues, and insurance limitations.

Ministering to the suffering is a challenge everywhere. I pray for my colleagues in Africa that God will give them patience in dealing with inadequate electrical power and corrupt political officials while at the same time I pray for my colleagues in America as they deal with twisted insurance prerequisites and drug addicts.

One young woman came to me last week. We’ll call her Veronica, although of course that’s not her real name.  She had a festering wound on her buttock that she’d just been seen for two days prior.

“Have you been taking the antibiotic that was prescribed?” I inquired as I looked over at Veronica, shifting uncomfortably on the exam table, dressed in a gown with a sheet over her lap.

She grimaced and I noticed little sweat beads across her forehead. Her blood pressure was a bit high too. “Yes, Doctor, but I’m not any better.” She shook her head for emphasis. “The pain is unbearable. I can’t sleep at night.” Tears welled up in her eyes as she spoke of the suffering. “I just can’t take it anymore.”

I bent over to examine the infected area on her body.

“Ouch!” she jerked away involuntarily as I touched the sore, red, spot on her skin. “Sorry,” she apologised and braced herself as I took another try at examining the infection. She winced but managed to hold still the second time.

The skin was red and inflamed and acutely painful. Without proper treatment of the infection, it could spread to the rest of her body, potentially landing her in the hospital on IV treatment if things weren’t taken care of today. I wondered why the original medications hadn’t seemed to help her. On reviewing her case, it appeared that appropriate measures had been taken. She should have been getting better by today.

“Given the fact that you’re still not improving even though you’re been taking what normally is the right medicine for this infection, I’m going to change the antibiotic,” I informed Veronica.

She nodded, grim-faced.

“I’m going to order an ultrasound exam to make sure the infection hasn’t formed a pocket of pus deep inside that might need draining too.”

Again, she nodded her understanding.

“And because I want to make sure this infection gets under control as quickly as possible, today I’m going to order for the antibiotic to be given as an injection.” I paused waiting for her response.

“Ok, doctor,” she nodded in agreement.

Satisfied that I was making the correct medical decision based on her symptoms, her exam, and the failure of her infection to respond to the initial first-line antibiotics prescribed a few days earlier, I went about typing in the orders into the computer.

“But, doctor, what about the pain?” she broke the monotone of my typing.

“Are you using ibuprofen and Tylenol?”

“Yes, but its not enough. I can’t sleep,” she winced again as she shifted her weight.

“OK, well,” I glanced at the last prescriptions given a couple days ago by the urgent care doctor, “I’ll refill the Vicodin (narcotic) pain killer that you were given before. Take it with the ibuprofen though,” I instructed.

“OK,” she relaxed.

“Now go do the ultrasound right now and get that first injection of the antibiotic,” I cautioned as she prepared to leave.

She shook my hand and thanked me.

I handed her the prescription for the Vicodin and the instructions for the ultrasound and injection.

That was the last I saw of her.

I waited for the ultrasound report. It never came. I looked her up in the computer system. She’d never gone for the test. I noticed that the Vicodin prescription had been picked up. The antibiotic prescriptions had not been filled.

I hate being snookered.

My first reaction was anger. It made me angry that Veronica would lie  and manipulate me and the medical system just to get a few narcotic pain pills. Later, I felt rather sorry for her. She wanted those pain pills so badly that she was willing to put her own physical health at jeopardy by neglecting proper antibiotic treatment for a real infection. 

Veronica was actually sicker than I’d originally assessed. It wasn’t an obvious illness amenable to a few tablets of antimalarials or antibiotics though, sadly. It was a deeper illness of the mind. Addiction.

Unfortunately, addicted and twisted minds wrapped up in a milieu of complicating psycho-social factors are not easily ‘fixed’. It takes more than a primary care doctor and a 10-minute clinic appointment to help heal the underlying suffering. Perhaps that’s why there is so little personal job satisfaction in these situations. It’s easier to prescribe a cream for the scabies rash or a worm tablet for the tummy ache or a course of Coartem (antimalarial) for the malaria.

Broken people are all around. In Africa. In America.

Perhaps some different flavours of illness hit my radar here in America versus Africa. I am trying not to compare though. Illness comes in all colours, shapes and sizes. I am continually astounded by the magnitude of broken souls that I meet.

It doesn’t matter whether it’s Africa or America, Asia or  Australia. People come with deep, penetrating wounds – raw and festering – expunging shame, guilt, depression, anxiety, unfaithfulness, and violence.

The song “people need the Lord” seems rather appropriate. God is teaching me to avoid the comparison game that only brings discouragement to my heart. Instead He is telling me to simply go forward and treat each person, whether it’s one or one-hundred, with the same love and grace that He extends to me.

Isaiah 61: 1-4 

The Spirit of the Sovereign Lord is on me,

because the Lord has anointed me

to proclaim good news to the poor.

He has sent me to bind up the broken-hearted,

to proclaim freedom for the captives

and release from darkness for the prisoners, a

to proclaim the year of the Lord’s favour

and the day of vengeance of our God,

to comfort all who mourn,

and provide for those who grieve in Zion—

to bestow on them a crown of beauty

instead of ashes,

the oil of joy

instead of mourning,

and a garment of praise

instead of a spirit of despair.

They will be called oaks of righteousness,

a planting of the Lord

for the display of his splendour.

X-Rays: a la Cameroon Style!

Medical care in Cameroon can be a little different as it is delivered in a culturally unique manner. Getting an x-ray in a foreign country can push one out of their comfort zone and yield surprising results.

~o~

I hate doctors.
Yes, I know. I am a doctor. That doesn’t mean I like being sick, being a patient, being on the “other side” per se. When the roles are reversed, my stomach churns with anxiety and my palms sweat with fear. I make a very good doctor. I make a lousy patient.

But, pain is an unremitting taskmaster.  Funny how convincing she can be?!

The receptionist smiled at me as I approached the radiology suite along the main road in Buea. I often walked past with my dog for our afternoon walks. Most of our client-patients utilized their radiology services for x-rays. The staff knew me well.

“Good afternoon,” I greeted the receptionist. I looked around the front room of the office. Only a couple of other young men, I couldn’t tell if they were supposed to be working or potential clients, lounged against the wall in conversation.

“I want to make an x-ray,” I addressed the receptionist.

“For you?” Her eyes startled open a centimeter.

I nodded. “Yes.” (So much for an incognito entrance).

The receptionist turned and walked into the back. I had no idea why she’d left so abruptly but I wanted an x-ray, preferably now, so I stood at the counter, waiting, exchanging uneasy glances at the young men in the waiting area. Both of us probably wondering what the other was thinking.

“The doctor says it is ok,” the receptionist reappeared abruptly to my left.

I turned to face her. “Oh, good.”

Just then, a very enthusiastic French-speaking radiology technician appeared from the back hallway.

“Vien, vien,” she motioned with her hands to follow her.

“X-ray?” I hoped that the doctor had translated the instructions for which x-rays to obtain. I had serious doubts that she would otherwise know what to do.

“Please, God,” I breathed silently as I followed her to a small room in the back with an army-grade x-ray machine. It looked as if it had survived a few wars.

“Chest,” I pantomimed as my whirling dervish technician briefly paused in her swirling activity to contemplate her next move.

She nodded excitedly. A bit too enthusiastic for my comfort, I’m afraid. How could anyone be so enthused over a black and white photograph of someone’s insides? But, what else could I do. Hope for the best.

The technician’s face lighted up and suddenly she made up her mind. With rapid hand gestures she motioned for me to strip off my shirt and hang it on the hook on the door of the room.

“Now?” like right now in front of her with an open door and curious young black gentlemen just around the corner? I hesitated.

“Now,” she nodded impatiently with a look that said she couldn’t understand why in the world I’d dawdle to take off my shirt.

So, off came the shirt, and bra. I hung them on the door. She smiled happily and quickly scooted me over to the wall and the x-ray’s photo plate board. I turned one way. She frowned and turned me the other way.

We were like a mismatched dancing pair for a few awkward moments. She’d step one way and mumble French directions that I couldn’t understand. Perhaps they were French insults but I’ll never know. She was smiling the entire time so who could tell.

She tried to direct my inept steps toward the correct arrangement. Left, no right but not that much right. Shift forward but not quite so far. She pushed and prodded me inches one way and another way. Finally, she seemed satisfied that her subject matter, me, was properly posed.

“Stay,” she motioned with her palm with a big grin, clearly pleased at her success in posing me properly for her film. I swallowed and tried to be the compliant client in spite of my misgivings. I really didn’t want to repeat this tango again.

“Should I take a deep breath?” I figured somewhere in this process, lungs should be inflated for a proper film.

The technician nodded her head earnestly. I wondered if there was anything she’d not agree to by this time. All the time she chattered away in rapid fire French. Whatever I thought she might be saying was truly a guess.

Somewhere within my asking if I should take a deep breath and hold it and her enthusiastic chatting, she took the x-ray. I still cannot pinpoint the precise moment, but she effortlessly came round from the back of the machine and indicated that I could shift from my nose-to-wall position. Not that the wall was so bad to stare at but it was a little monotonous. All white and all. The wall was probably bored by staring at me too.

Another round of tango ensued in which the French technician tilted and bent my body to her tastes, cheerfully giving out instructions in French that could have been in Klingon for as much as I could understand. In spite of my foibles at anticipating her instructions, her smile never wavered. As I practiced being a human Gumby – remaining stationary after she shifted my limbs into the correct position – she clucked encouragingly. She was pleasant, at least. Our communication abilities were less than ideal but at least she was friendly.

For the second picture, I didn’t try to coordinate the whole breathing thing. I focused on the other wall and basically tried to not stir. She stepped behind her machine, fussed over the knobs a bit, and finally re-emerged, still smiling.

“Done?” I asked hopefully. She took the correct number of films. I decided that was a promising sign that she’d also taken the correct views.

“Yes, yes,” she answered. She walked briskly off to develop the films. I re-clothed myself, thankful the place didn’t have any other clients waiting. I’m not as modest as when I was a teenager, mind you. Still, I have noticed that white-man skin tends to attract an unwanted curiosity on the part of my darker skinned community. Not the kind of attention I crave.

At the counter, I paid the customary 5000 XAF ($10) for the x-ray. Turns out one of the young men lounging against the wall was supposed to be the cashier. X-rays in Cameroon are probably a bit cheaper than those in America. Granted, of course, there was no electronic data file available. And, although the radiology technician was happy with her work, the quality of the black and white film was a bit fuzzy in areas with some developing fluid drips staining the lower portion. The good news, the pictures were adequate. I didn’t have to repeat them.

And the other good news?

The electricity went off just AFTER my x-rays, not to return until the next day.

And the x-ray pictures results?

Well… the radiologist’s interpretation is at least unique. I doubt I’ll ever get another read on a chest x-ray that says, ‘…small heart!!!’. Not sure if the triple exclamation marks were necessary…

~0~

 “Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but - I hope - into a better shape.”
― Charles Dickens, Great Expectations

Eleven Differences I Notice Since Living Overseas

Author note:

It seems everyone is making up their “top ten” lists these days. I thought I’d join the foray with my own few observations. Those of you who’ve spent any length of time in a foreign culture may relate.

~o~

"The world is full of obvious things which nobody by any chance ever observes." 

- Sherlock Holmes in The Hound of the Baskervilles, ACD.

~o~

10 11 THINGS I’VE NOTICED SINCE LIVING IN CAMEROON 

(note the word “Cameroon” -- not “Africa)

1. Television Commercials Are Annoying

How many times do I need to be reminded how I must be unhappy until I buy items that I don’t really need? I have never been a fan of commercials but recently, when I watched the season premiere of a favorite television series I follow, I was seriously put out by the multitude of hyper commercials advertising for services and things I wasn’t even remotely interested in spending money upon. Those commercials for prescription medications were particularly inciting on so many levels.

2. People Are Multicultural

Americans are just that – Americans. The United States is a country of immigrants. I can’t define people as black or white or Hispanic or Asian anymore. Each person has their own unique heritage. The lovely Greek lady at the supermarket was a treat to meet. Her accent brought up sunny memories of Greek island beaches and delicious Feta cheeses.

3. American News Channels Are Terribly Biased

I have been privileged to live in different countries and talk with peoples from a vast array of cultural backgrounds. America is not the only country in the world. There’s so much more. The local news channels strike me as bordering on brainwashing. I want to shake the radio and yell, “Wake up, people! There’s more than three top stories happening in the world!” Ok. Deep breath. I’m thankful for the internet and the opportunity to glean from news agencies outside U.S. borders.

4. There Are A LOT of Choices/Options

OK. So much has already been said about the gigantic variety of choices that Americans are presented with wherever they go. I remember going to PetsMart and wondering to myself, “How many different kinds of flea product are really necessary?” The entire left-hand side of the isle was stocked with an overwhelming plethora of choices. I certainly didn’t have the time to read every label and do a statistical analysis of price versus quality versus reviewer rating before buying a product that would rid my dog of fleas.

 5. The U.S. Is Full of Emptiness

I take my dog for a stroll along the country roads. Each house I pass with manicured lawns and blooming flowerbeds is still and silent. The windows are dark. No dogs bark. No children bounce around the yard. My husband and I drive to the park. One other person with his son walks around the track with their two dogs. We drive along the freeways, only in the centre of Washington DC do the roads seem congested with traffic. Elsewhere the streets have plenty of space between vehicles. No motorcycles or pedestrians crisscross the lanes either. The neighborhoods seem eerie and empty.

6. Excessive Signage

In Cameroon, there are no street signs marking the names of streets/roads/paths/etc. This is generally not a problem since most roadways do not have official names; and, if they do, they’re not very descriptive or unique. Buea is full of streets termed ‘street one’, ‘street two’, street three’, ‘street four’, and such forth. Each different neighborhood/quarter has its own set of street numbers and unless someone specifies the neighborhood, one cannot differentiate which ‘street one’ is being mentioned. There are the basic traffic signs in Cameroon too. A few stately STOP signs grace the intersections suggesting to the taxi drivers that they might want to consider reducing their speed before crossing the thorough-way. I've never heard a foreigner complain about an overabundance of signage though. In contrast, take the intersection her in Virginia where I’m spending a few days. The Interstate 95 bisects Route 17 at the 4-way stoplight. There’s a digital WellsFargo Bank blinking the temperature of the moment. Another sign warns “Do Not Block Intersection”. The Sleep INN proudly boasts a ‘fresh look, complimentary hot breakfast, and wifi’. To my right there are signs directing traffic one direction, other signs announce, ‘End Work Zone’, ‘Over Height Do Not Pass Under Bridge’, “End Road Work’, ‘Left Lane Ends Merge Left’. To my left are more signs declaring, ‘Unmarked Pavement’, ‘One Way’, ‘Stay in Lane’, and ‘Exit’. Every empty patch of dirt appears taken with a signpost and the traffic signal poles are strapped with flyers and notices. There’s even a tiny white plastic spike with the writing ‘Caution Water Valve’ imbedded intoa scruffy tuft of remaining green grass. Signs, signs, and more signs. I’m feeling lost in the exuberant enthusiasm of the written posted verbosity.  Let’s not start on the cereal cartons!

7. America is the ‘Land of Many Toilets’

I’m not claiming the U.S. has more bathrooms than other countries. Cameroon has plenty of unofficial potty spots. In reality, any dim alley can serve as an emergency bladder-relief spot if necessary. However, in general, bathrooms are not as readily accessible, available, and convenient as the States. The supermarkets here in America have multi-stalled bathrooms freely available to their customers. Every Café maintains at least one fresh-smelling toilet. Quaint city parks with mere acres of grass and a tiny walking path still have at least a men & women bathroom facility. There’s nowhere I can go where I’m terribly inconvenienced by my bladder’s demands. I’m not complaining about this, mind you. It’s nice not having to plan my oral intake levels based on future availability. I must admit that I’m still getting used to the new norm of flushing the toilet EVERY time. The old adage, ‘when it’s yellow, let it mellow….’ Is harder to contradict than one might imagine. I find myself still calling out, “Bill, do you need to use the toilet before I flush?” at bedtime. 

8. The Supermarket, A.K.A. Food Supply, Is Far Far Away

In Buea, at the end of my workday, Jordan (our dog) and I would stroll around the neighborhood. I’d get my exercise, Jordan would get her excise, and we’d both find supper. Living on the outskirts of town right now, I find it takes at least fifteen minutes, by car, to reach the nearest supermarket, or really any store for that matter. Shopping and sleeping are much farther apart in the States as compared to life in Cameroon. No wonder everyone owns a car.

9. Where Are All the Ants?!

Ok. Ok. I admit, I’m not the most nit-picky house keeper. Our house in Buea was generally swept and the dishes at least in various stages of being cleaned; but, no one would have pinned a blue ribbon on the place giving me a Martha Steward award. Still, I learned to put every open food packaging in the fridge immediately after use. Where’s the sugar for the tea? In the fridge. What about the bread? In the fridge. No matter how minuscule the food particle, if it laid out on the kitchen counter for more than five seconds, the ants would come. Tenacious, persistent, incredibly intelligent little scavengers that could burrow their way into almost every form of packaging…even occasionally the as-yet unopened ‘sealed’ cartons. 

And now? There are freshly baked muffins cooling on the counter top without a hint of an ant. A small amount of sugar from the sugar bowl in the cupboard spilled this morning. Nary an insect has come. The candy sits in the candy dish without disturbance. The biscuits sit in the pantry in an already opened wrapping without a bug. The lights above the dining table shimmer alluringly but no flying six-legged critters fly overhead or fall into our stew. Amazing!

10. Small Change Lasts Forever

Thanks to Visa and MasterCard, the coins and dollar bills sit around in my change purse forever. No more searching for change. No more waiting until the end of the day when the pharmacy might be able to break a 10,000 XAF bill into spendable 1000 and 2000 XAF paper bills. My quarters and nickels wait patiently until the next parking meter, which is the only time I use cold, hard coins these days. The convenience is handy. My math skills in addition and subtraction that I’d use to ensure my purchases added up to a suitable round number that the clerk had change for, and then double-check the leftover change, are dwindling. 

And...since I couldn't contain my list to ten...

11. Fuel Prices Are Variable

My father has an app on his iPhone to help him locate the pumps with the least expensive fuel prices. One doesn’t have to drive too far to pass fuel stations with all sorts of different prices advertised; and, they change daily! Even fuel stations adjacent to each other advertise different unit prices per gallon. In Cameroon, during my five years, due to government regulations, the fuel price changed once. Very standardized. The fuel prices were not cheap but they were consistent. 

Obviously, many other cultural nuances and differences assault my observations these days. I'd love to hear from you and see what differences you've noticed internationally speaking.