faith


I betook myself to the Coptic Pascha evening service tonight after work. I missed Palm Sunday service through falling asleep post-call, and not being able to muster the energy to get myself out of bed after a 15min nap. So I felt bad about that, and I considered giving up on the enterprise of keeping Pascha and working 13-15hrs a day at the same time. But then there wouldn’t be an Easter that meant anything to me, and that would ruin the whole year, and that would be pretty bad.

So I dragged myself to church after work, not entirely thrilled about a 1hr round trip, and two hours of service (allowing for missing the first hour, and skipping the last 45min due to the sermon being entirely in Arabic).

Somebody please kick me the next time I consider missing Coptic church. I was so glad to be there. I didn’t know many of the people, and I didn’t have a service book. But we were praising God and commemorating Christ’s passion, and there is nothing better in the world.

Thine is the power, the glory, the blessing, and the majesty, forever, Amen.
       Emmanuel, our God and our King.
Thine is the power, the glory, the blessing, and the majesty, forever, Amen.
       My Lord Jesus Christ, my Good Savior.
           The Lord is my strength and my song, and has become my salvation.
Thine is the power, the glory, the blessing, and the majesty, forever, Amen.

The Copts are my identity, one of the only things about me that’s still the same at the end of this year. At that church, everything is right and in order.

(Man cannot live by bread alone; and neither can one get by entirely with Presbyterian church services, especially the strict ones. They’re missing something, like icons and incense and color and music. I should point that out to the elders of the church I’ve been going to. The reaction at least would be interesting.)

I’m looking for opinions/advice on how to deal with people doing impressions of others. A lot of the guys here like to do “impressions” of various attendings. To me it feels like mocking them for being older than us, or for having a pet phrase or two, or for always approaching a problem in the same way. I’m not sure whether it’s mocking, though. They don’t do it as much about the attendings we don’t like as about the nice attendings. But of course they wouldn’t do it if the attending was around, and I’m pretty sure the attendings wouldn’t like it if they heard it. I wish I could stop these conversations, but I don’t know what to say.

Ok, that’s the Dear Abby section for today. Now, some stereotypes from another angle:

Another group that my colleagues like to do imitations of are medicine residents in general (not one in particular). At one point today I had decided that was really enough, and we were setting a bad example for the medical students, and I needed to do something to slow it down, or at least demonstrate that we do respect our colleagues. And then we got a consult from the medical ICU, and the medicine resident said, at various points in the conversation, “I know there’s nothing you can do for this guy, but my attending said, ‘He’s crashing, and I’m not sure what to do about it; consult surgery.’ . . . Yes, I’ve been here all morning; it took me four hours to put in a central line, that’s why I didn’t call you earlier. . . Sure, take the chart, I’m going to be writing a note here for quite a while longer [1hr, by my count]. . . We were going to get an ultrasound to evaluate the ascites. You guys don’t do that kind of thing, do you? You just touch it.”

That, my friends, is an admission I could not make up. Every single medicine stereotype that the other surgery residents had been quoting to the med students, in living color – from one of the smartest, most competent (except for lines) medicine residents. He knew the consult was ridiculous. At least he called us about it, and we had an intelligent conversation about the patient. (And as for the ascites, yes: we had a CT, and an abdominal exam. No need to be repetitious with the ultrasounds, except if you intend to tap it. At the beginning of this year, I was puzzled when called upon to say whether someone’s abdomen was distended or not. I couldn’t tell the difference between distention (which is usually pathological) and obesity (which is physiological – not an immediate surgical pathology). I’ve learned the difference now, though. Distention, even an obese person, gives a different texture, a different quality under the skin. It’s fluid, or air, that shouldn’t be there; and you can sense how the skin is stretched in an unusual way to accomodate it.)

And then finally, another group whom I have decided to abandon all scruples concerning, and make bitter and sarcastic remarks about without reserve: the ER, and especially the ER residents. I think, honestly, ER doctors with specialty residents in-house are obliged to do better than this, because they think a bit longer before calling an attending in from home, than before calling a resident down the stairs.

Today, ten minutes before sign-out, we got a page from the ER, for a young man who had arrived only 15 minutes before. (I know, because we were down there evaluating a genuine surgical issue when the fellow was brought back.) The consult was for appendicitis in a patient with no other medical problems. No labs had been done, and certainly no imaging. We went to see the patient, and a few moments later informed the ER resident that in our opinion, a young man with groin/testicular pain as well as right lower quadrant pain, who had a history of both kidney stones and Crohn’s disease, deserved a little investigation into other possible causes of pain (testicular torsion, kidney stones, Crohn’s disease) before being summarily dumped on the general surgery service as an appendicitis. (If it were one of those other causes, he should have been sent to urology, or colorectal surgery, or even plain medicine.) So I apologize to the excellent ER doctors in the blogosphere, but I’m giving up being polite about the ER for right now. From here on, I’m going to fight every call from them until it’s been properly – even exhaustively – worked up. And all stereotypical jokes are fair game. As my chief remarks, we’re not asking them to think like surgeons, just like doctors. Examine the patient and think for two minutes!

(My patient is dying of cancer, and I can’t fix him, I can’t help him, I can’t even make him comfortable. Every time I go to see him, he holds my hand and cries. I hate cancer. My patients are all sick, and I can’t fix them. I’m tired of sick people. Did you know everyone in the hospital is sick? I forget what healthy people look like. All my patients end up in the ICU. The world is broken and I can’t mend it. . . The creation also shall be delivered from the bondage of corruption into the glorious liberty of the children of God. The whole creation groans and travails in pain together until now; and not only they, but we also, who have the first fruits of the Spirit, groan within ourselves, waiting for the adoption, to wit, the redemption of our bodies. And we are saved by hope, but hope that is seen is not hope, for what a man sees, why does he yet hope for? Likewise the Spirit also helps our infirmities. . .)

Dr. Schwab’s Surgeonsblog is one of my favorite blogs ever. He has tremendous stories, and tells them very well, and I am inspired by his example as a caring and competent surgeon.

Lately, though, he’s taken to posting political and religious rants (his word) on the weekends. Creationists are a common target. I’ve got to respond to his latest post, but so many ideas came to mind I thought it would be better to write on my own blog.

Dr. Schwab’s post opens with an 8min clip of an ABC news segment on two creationist men who give tours of a Denver science museum to Christian homeschoolers, giving the creationist point of view in contradiction to the evolutionary teachings of the museum.

First, two things about the video: the two men, while I applaud their beliefs and their activism, are not the best possible spokesmen for young-earth creationism. When asked how long the period was between Adam’s creation and Noah’s flood, they stumble, and end up guessing that there were six or seven generations. In other instances, I agree that their responses are simplistic. If they know of the scientific evidence for creation, they’re not adept at mentioning it when called on. In their defense, this could be due to the young age of the children; most of them look to be in early elementary school. A disquisition on carbon-dating would be over their heads. I would bet that if you filmed an elementary school tour led by an evolutionist, there wouldn’t be much more sophisticated discussion than there was here. However, the ABC producers slanted the segment nastily. When the two creationist spokesmen guessed that there were six or seven generations of 800-yr olds between Adam and the flood, they multiplied 800 x 7 and got 5000+ years, making the creationists look ridiculous. Actually, the egg should be on ABC’s face. You don’t multiply generations like that. Each generation ought to start 20-40 years after the previous one. Better informed young earth theorists add up the genealogies in the Bible to make 1500 years between Adam and the Flood. There are other ways, as well, in which the producers went out of their way to pick soundbites that would make the creationists look bad. You might also notice that their claims, and those of the evolutionary scientist at the museum, are equally without evidence – in this video. Those watching this news segment were being asked to choose between creation and evolution based simply on the mockery of the museum’s scientist and of the producers.

(For further information on all kinds of questions regarding creation science, check out Answers in Genesis (specifically the answers page) and the Institute for Creation Research, which give much better evidence-based and Bible-based reasoning than the tour leaders in that video were able to do.)

 Now, to Dr. Schwab’s comments. He says,

My reaction to the above video goes beyond anger: it makes me sick. These kids are deliberately being deceived. Brainwashed. And, yes, abused.

My question to Dr. Schwab is, who doesn’t brainwash their kids, by his definition? Children sent to public schools and taught to believe that the entire universe sprang into existence on its own (where, after all, did the material for the Big Bang come from?), and that random atoms then coalesced into organic molecules, which then arranged themselves into the infinite complexity of data coding which is DNA, and that information was somehow progressively added into the system, making more and more complex organisms, until their own intelligence randomly developed – are they not being “brainwashed” as well? They’re told that these are the facts, this is how life is, this is what they should believe, and the alternatives are mocked and laughed at, if they’re even mentioned at all. All parents want to teach their children the same things that they believe. That’s not abuse, that’s good parenting. If you, as an adult, believe that you know what is true, you want to protect your children and save them from the painful errors that you yourself may have made. I’m sure Dr. Schwab would not be thrilled to let a creationist lecture to his children. Neither would creationists want evolutionists teaching their young impressionable children – although most of us do encourage the study of the theory of evolution for older children, say highschoolers.

But this is the part that really annoys me:

They are being led to extremism which differs not from the kind that creates believers in paradise filled with virgins. And we know where that leads.

I respect Dr. Schwab’s right to believe whatever he wants about the origin of life and the universe, and to make his arguments for what children should be taught. But to accuse Christian creationists of being morally on a par with Islamic suicide bombers is – I think slander is the right word, although more loaded than I’d like for a polite discussion. There is nothing, nothing, nothing in orthodox Christian teaching which would in any way condone the killing of other innocent people simply to make a point. You cannot show a single instance in recent history of Christians, acting on teaching which has anything near polite acceptance in the Christian community, killing other people. (The rare instances of killing abortionists don’t count: the number of Christians who would approve of this is vanishingly small, too small to count in a percentage.) Islam, on the other hand, teaches repeatedly and clearly, throughout the Koran and the hadiths, and among the vast majority of imams, that it is not only right, but necessary, to kill unbelievers. Creationism, which teaches children that they were made in the image of God (and therefore they should respect and value their own bodies and the lives of others) comes nowhere near this kind of violence.

Dr. Schwab continues:

These are the people putting religious tests to our potential leaders, proclaiming their holiness above mine . . . banning books and destroying public education. Rioting over cartoons. These are the people claiming our country needs more religion, even as their religion-above-all attitude is subverting the very foundations of our democracy and aiming us toward societal failure by substituting indoctrination for education.

What can I say? I learn from the Bible to proclaim, not my holiness, but my sinfulness – and God’s holiness and mercy. My homeschooling family, and those like us, are not destroying public education, but trying to rescue our children from an educational system which has already failed disastrously (school shootings on a regular basis, drugs available in schools, high school graduates who can’t read or do simple math, high schoolers who can’t compete with most other developed countries in math and science, schools which spend more time teaching young children how to have sex than telling them basic facts about American history). When our religion is mortally insulted (as in the demeaning and gross “art” exhibits in New York a few years ago, which were far more insulting to Jesus than those cartoons were to Islam), we didn’t riot. We wrote polite letters to the editor.

I don’t want to make this sound like boasting, but in the homeschooling creationist community nationwide that my family is part of, there are many young people becoming doctors and nurses; we are acing the SAT and ACT, and are competitive applicants to the best universities in the country. My friends from college, creationists like me, went on to become biochemical researchers.

Dr. Schwab, your indignation would be better spent on the disaster that is the public school system, and the teachers’ unions who refuse to allow any changes, and the truly dangerous religious extremists (Muslims) rather than on a group which is simply trying to raise their children in peace to be good and productive citizens.

Last night I came across a couple of news articles about a prominent Italian Muslim (who, to be fair, hadn’t actually practiced Islam for many years) who converted to Christianity and was baptized by the pope as part of a televised Easter vigil service. I say congratulations to him, and admire his bravery. Magdi Allam, who took the name Christiano in the baptismal ceremony, already had one death warrant against him for his activism against Islam, and I am sure this very public conversion will earn him another.

Some media commentators, ever ready to deliberate on matters they don’t understand, questioned why the Pope would create such a public show. It seems consistent with his bold statements about the true nature of Islam, and I think he as well as Allam is to be praised for boldly confronting an issue which Muslim leaders would rather keep secret, that is, that conversion out of Islam deserves the death penalty under sharia law – law which is often effectively carried out by vigilantes or family members of converts in Muslim countries.

In American politics, I finally decided to read Obama’s famous race speech. I have to say, much as I disagree with his philosophy and his grasp of history, conservatives who denigrate his speaking abilities seem to be doing so unfairly. It is a rhetorically effective speech, well constructed, cleverly addressing all the key issues and defusing them. Not that I think he actually solved the question of his connection Jeremiah Wright, but he did the best possible job of explaining him and at the same time making the attacks on him part of a bigger picture.

News from the UK: Rules of the Koran are more important than hygiene, according to UK’s Islamic Medical Society. Actually, make that cultural standards, not Koranic rules, since the Koran itself doesn’t really specify the precise nature of modest women’s clothing. The imams have just taught that whatever they wore in Mohammed’s time has to have been the heavenly standard. Sort of like chronological snobbery taken to the extreme.

But yes. Now religious scruples trump scientific principles, and keeping a few inches of your skin covered is more important than taking good care of your patients. One wonders why these women are involved in health professions, anyway. Do they not find it disturbing, or at least hypocritical, to be looking at naked male patients, while they refuse to lift their sleeves enough to wash properly?

Here in the US, there’s an uproar if Christian pharmacists propose not to dispense abortifacient drugs due to their religious principles. And all they’re doing is offering a slight obstruction to health care (if you insist on calling the destruction of life health care) (and yes, this is weighted language to be using about RU-486). But it seems to be all right, at least by Muslim standards, to downright forcibly endanger your patient’s health because you’re so concerned about letting your wrists be seen in public.

I have some pretty high standards of modesty myself, but this is ridiculous and hypocritical. Let’s see whether the UK health community is able to respond appropriately, or whether the once-proud Britons have truly become slaves, the new dhimmis. (Which is the Arabic word for conquered peoples who are allowed a few protections as second-class citizens as long as they submit to all Islamic laws.)

O give thanks unto the Lord, for he is good: for his mercy endureth forever.
Let the redeemed of the Lord say so, whom he hath redeemed from the hand of the enemy, and gathered them out of the lands, from the east, and from the west, and from the north, and from the south.

They wandered in the wilderness in a solitary way; they found no city to dwell in.
Hungry and thirsty, their soul fainted in them.

Then they cried unto the Lord in their trouble, and he delivered them out of their distresses;
And he led them forth by the right way, that they might go to a city of habitation.

~ Oh that men would praise the Lord for his goodness, and for his wonderful works to the children of men!
~ For he satisfieth the longing soul, and filleth the hungry soul with goodness.

Such as sit in darkness and in the shadow of death, being bound in affliction and iron, because they rebelled against the words of God, and contemned the counsel of the Most High:
Therefore he brought down their heart with labor; they fell down, and there was none to help.

Then they cried unto the Lord in their trouble, and he saved them out of their distresses.
He brought them out of darkness and the shadow of death, and brake their bands asunder.

~ Oh that men would praise the Lord for his goodness, and for his wonderful works to the children of men!
~ For he hath broken the gates of brass, and cut the bars of iron in sunder.

Fools because of their transgression and because of their iniquities are afflicted.
Their soul abhorreth all manner of meat; and they draw near unto the gates of death.

Then they cry unto the Lord in their trouble, and he saveth them out of their distresses.
He sent his word and healed them, and delivered them from their destruction.

~ Oh that men would praise the Lord for his goodness, and for his wonderful works to the children of men!
~ And let them sacrifice the sacrifices of thanksgiving, and declare his works with rejoicing.

They that go down to the sea in ships, that do business in great waters:
These see the works of the Lord, and his wonders in the deep.
For he commandeth, and raiseth the stormy wind, which lifteth up the waves thereof.
They mount up to the heaven, they go down again to the depths; their soul is melted because of trouble.
They reel to and fro, and stagger like a drunken man, and are at their wits’ end.

Then they cry unto the Lord in their trouble, and he bringeth them out of their distresses.
He maketh the storm a calm, so that the waves thereof are still.
Then are they glad because they be quiet; so he bringeth them unto their desired haven.

~ Oh that men would praise the Lord for his goodness, and for his wonderful works to the children of men!
~ Let them exalt him also in the congregation of the people, and praise him in the assembly of the elders.

He turneth rivers into a wilderness, and the watersprings into dry ground; a fruitful land into barrenness, for the wickedness of them that dwell therein.
He turneth the wilderness into a standing water, and dry ground into watersprings;
And there he maketh the hungry to dwell, that they may prepare a city for habitation, and sow the fields, and plant vineyards, which may yield fruits of increase.
He blesseth them also, so that they are multiplied greatly, and suffereth not their cattle to decrease.

Again, they are diminished and brought low through oppression, affliction, and sorrow.
He poureth contempt upon princes, and causeth them to wander in the wilderness, where there is no way.
Yet he setteth the poor on high from affliction, and maketh him families like a flock.

The righteous shall see it, and rejoice; and all iniquity shall stop her mouth.
Whoso is wise, and will observe these things, even they shall understand the lovingkindness of the Lord.

~~Psalm 107 

This psalm is so many things in one: a record of God’s saving power to bring the Israelites out of Egypt to the Promised Land; praise for his work in bringing each one of his children out of the darkness and despair of sin into the light of his salvation in Christ; a description of his providence through all of life; and an invitation to all who find themselves in darkness and the shadow of death, in trouble or distress, longing and hungry souls, tossed by the tempests of life. Call to God in your distress, and he will answer and save you out of your troubles. I know that this is true. 

The other night we admitted a woman with a chronic condition in a very severe exacerbation. She sat huddled up in bed, looking very sick, and pretty much refusing to talk, so most of the history came from an attentive husband. He explained that she’d been diagnosed some seven years ago, “but in 2002 she was healed, so she hasn’t needed any medicines since then.” Umm, right. Turns out she had been in the hospital once in between, but whether because of a misdiagnosis at that time, or because of patient refusal, had not restarted the usual medications. The husband concluded his explanation of the most recent events by saying, “We’re born-again Christians, and we’re just waiting for Jesus to heal her.”

I gave them a fairly supportive answer, and went to report to my senior, who uses Jesus’ name frequently, but not with any decency. I felt obliged to mention their story about healing, since they would undoubtedly tell it to him when he went in, and because it was rather relevant as an explanation of why her disease had been untreated for so long. He shook his head. “That’s nonsense. You can’t be healed of that disease.” Although not the ground I would have chosen, I felt obliged to say something, because I don’t intend to spend the month listening silently to his atheism. “Well, theoretically, I think you can be healed of anything.” “Not metastatic disease!” “Well, yes, that too, if God wants too. Nothing is impossible for God.” “That’s your philosophy.”

But I do wish these folks would have some better sense of tactics. It’s bad enough trying to tell any doctor that you’ve been miraculously healed; it produces a less skeptical response if you actually have been healed, or at least have minimal symptoms. Being on death’s door and requiring an operation is not the position from which to state that you’ve been healed. Please, folks; it makes it hard for the rest of us. (And for consistency’s sake, and politeness, don’t show up to the hospital and let yourself be admitted, and then insist to all and sundry that you’re just waiting for supernatural healing. If you’re here, you have to admit to God’s use of means on occasion.) (But I would still be thrilled if she were miraculously healed, just for the sake of my atheist colleagues.)

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