The prayers of the first hour of Thursday are greatly extended by the ceremony of foot-washing, which is preceded by prayers and litanies in the style of the liturgy, but with special songs for this occasion.

Doxology of the Archangels
Seven archangels stand glorifying the Almighty, and serving the hidden mystery.
Michael is the first; Gabriel the second; and Raphael the third, a symbol of the Trinity.
Surael, Sadakael, Sarathiel and Ananael: these are the shining ones, the great and holy, who ask him for the Creation.
The Cherubim, the Seraphim, the thrones, the dominions, the powers, and the four incorporeal beasts, bearing the chariot of God:
The twenty-four priests, in the church of the First-born, praise Him without ceasing, proclaiming and saying:
. . . Holy, Holy, Holy, Lord of Hosts, heaven and earth are full of your glory.

Doxology of Saint Mark (apostle to Egypt)
O Mark, the apostle and the evangelist, who witnessed the passion of the only God,
You came and enlightened us with your gospel, and preached to us of the Father and the Son and the Holy Spirit.
You brought us out of darkness to the true light; you fed us with the Bread of Life which descended from heaven.
All the tribes of the earth are blessed by you, and your sayings have gone out to the end of the world.
Hail to you, o martyr; hail to the evangelist; hail to the apostle, Mark, the beholder of God.
Ask the Lord for us, O beholder of God, the evangelist, Mark the apostle, that he may forgive us our sins.

before the creed, which is recited with the omission of the phrases about the crucifixion and resurrection:
Glory be to thee, O Christ, our Master and our King, the honor of the apostles, the crown of the martyrs, the rejoicing of the righteous, the confirmation of the churches, the forgiveness of sins. We proclaim the Holy Trinity, one in essence. We worship him and glorify him. Kyrie eleison.

And then, one of the most haunting hymns of the whole week, with the refrain “Ioudas ho paranomos,” which is the Coptic-borrowed-from-Greek for “Judas, the law-breaker.” (Bear in mind that much of the rhythm and poetry of these songs are lost in translation; but the meaning and theology remain.)

With silver you have sold Christ to the Jews, who have broken the law. They, who were contrary to the law, took Christ and nailed him on the croos in the place called Kranion.
Barabas, the thief and the condemned one, was set free, and the master, the judge, they crucified. They thrust a spear in your side; and as a thief they nailed you on the cross, and they laid you in a tomb, o you who raised Lazarus from the tomb.
As Jonah stayed three days in the belly of the whale, so our Savior stayed three days. After he died, they sealed the tomb.
Truly he rose, but the soldiers were not aware; truly, the Savior of the world has risen, he who suffered and died for our sake. O Lord, glory be to thee!

The story of Abraham and Isaac is read, interspersed with several mournful chapters from Job. Then, the water is blessed, in a ceremony including what looks like a harvest of all the passages in the Bible concerning water and hospitality, from the visit of the three men to Abraham, to the promise in Isaiah to wash the sinner with hyssop, to the mysterious prophecy in Ezekiel about the rising rivers, to Wisdom in the book of Proverbs preparing her house for a feast. The priest wraps a towel around his waist and kneels down to symbolically wash the congregation’s feet, making the sign of the cross on their ankles. (Ok, very symbolic.)

When the gospel readings progress to Christ’s actual institution of the Lord’s Supper, the service slips from simple prayers of the hours into the liturgy, but a shortened liturgy, in which no cymbals are used (congregants are also forbidden from greeting each other with the usual Middle Eastern kiss from this day till the end of the week, in remembrance of Judas’ traitorous kiss), the epistle readings are omitted, the creed skips the crucifixion and resurrection again, and the prayers for the dead are omitted, since at this point in time one would have no basis for them. This liturgy is the fullest instance of the Copts’ philosophy of the Holy Week: to relive exactly what the disciples witnessed, exactly what Christ went through (because he knew, just as we do, what the week was moving toward on Friday), simply with the addition of the Old Testament passages which should have explained everything to the disciples. The Fraction prayer of this liturgy is a long theological disquisition on Christ’s substitutionary sacrifice being foreshadowed in the ram which replaced Isaac. I have often heard the priest’s voice break as he comes to the father’s agony in this prayer. (So much for the charge of rote prayers without meaning. These prayers are very much prescribed, but quite the opposite of meaningless or impersonal.)

The prophecy of the eleventh hour is Isaiah 53, the famous Messianic prophecy called The Suffering Servant: “Who hath believed our report, and to whom is the arm of the Lord revealed? For he shall grow up before him as a tender plant, and as a root out of a dry ground. He hath no form nor comeliness, and when we shall see him, there is no beautfy that we should desire him.
“He is despised and rejected of men, a man of sorrows, and acquainted with grief. We hid as it were our faces from him; he was despised, and we esteemed him not.
“Surely he hath borne our griefs, and carried our sorrows; yet we did esteem him stricken, smitten of God and afflicted. But he was bruised for our transgressions; the chastisement of our peace was upon him; and with his stripes we are healed.
“All we like sheep have gone astray; we have turned every one to his own way; and the Lord hath laid on him the iniquity of us all. . .
“Yet it hath pleased the Lord to bruise him; he hath put him to grief. When thou shalt make his soul an offering for sin, he shall see his seed, he shall prolong his days, and the pleasure of the Lord shall prosper in his hand.
“He shall see of the travail of his sould, and shall be satisfied. By his knowledge shall my righteous servant justify many, for he shall bear their iniquities. . .”

The psalm:
Seeing thou hatest instruction, and castest my words behind thee: when thou sawest a thief, then thou consentedst with him, and hast been partaker with adulterers.   Ps. 50:17-18
And then the gospel of how Judas went out to betray Jesus concludes the morning prayers.

Some psalms from the evening prayers; by now the chanting of these is almost a wail:

Hear my prayer, O Lord, and let my cry come unto thee.
Mine enemies reproach me all the day, and they that are mad against me are sworn against me.  
Ps. 102:1, 8

Deliver me from mine enemies, O my God; defend me from them that rise up against me.
Reproach hath broken my heart, and I am full of heaviness; and I looked for some to take pity, but there was none; and for comforters, but I found none.   
Ps. 59:1, 69:20

Why do the heathen rage, and the people imagine a vain thing?
The kings of the earth set themselves, and the rulers take counsel together, against the Lord and against his Anointed, saying,
Let us break their bands asunder, and cast away their cords from us.
He that sitteth in the heavens shall laugh; the Lord shall have them in derision.    Ps. 2:1-4

The gospel readings being the last discourse in John, the prayers in Gethsemane, the arrest, and the midnight trial before Caiaphas, along with Peter’s betrayal (please go read them yourself; they’re just too long to type in here, but they’re the culmination of all). This concludes some eight hours of prayer today, and sets the stage for an eight-hour vigil/drama during the day tomorrow.

A few more words on the arrangement of the Bible readings in the Pascha services: Monday covers creation and the fall. Tuesday, one hour had two straight chapters from Genesis on the Flood and the Covenant with Noah. Wednesday’s readings cover the exodus from Egypt (pointing forwards to the ultimate exodus in which Jesus, the second Moses, delivered his people from the spiritual land of Egypt, ie bondage to sin). Thursday, the Copts connect the Last Supper, which is in fact a beginning of the New Covenant, with the Abrahamic covenant, and consider the story of Isaac’s substitute at length. Intermixed are readings from Proverbs and the Wisdom of Sirach (the Copts accept the core books of the Apocrypha, but not as many I think as the Catholics do) describing the beauties of Wisdom (which is a figure for Christ), and the blessings offered to men who follow her.

Some of the psalms for today (which are complicated to look up because the Copts use a system of numbering which sometimes matches the KJV, and sometimes doesn’t, and I haven’t figured out the trick yet):

. . . That thou mightest be justified when thou speakest, and be clear when thou judgest.    Ps. 51:4
(Which becomes full of meaning when one considers Paul’s use of it in Romans 3, to demonstrate that God’s righteousness stands firm, regardless of men’s sins, and goes on to show God’s glory in Christ’s death, wherein he demonstrates his own righteousness in judging sin, and also as sufficient to provide remission of sins for believers.)

For lo, thine enemies make a tumult; and they that hate thee have lifted up the head.
They have taken crafty counsel against thy people, and consulted against thy hidden ones.    Ps. 83:2-3
(This is read in conjunction with John’s account of Judas Iscariot murmuring against Mary anointing Jesus’ feet.)

Have mercy upon me, O Lord, for I am weak; O Lord, heal me, for my bones are vexed.
My soul is also sore vexed; but thou, O Lord, how long?
. . . And hide not thy face from thy servant, for I am in trouble; hear me speedily.         Ps. 6:2-3, 69:17

Deliver me, O Lord, from the evil man; preserve me from the violent man,
Which imagine mischiefs in their heart; continually are they gathered together for war.   Ps. 140:1-2

Besides the prophecies of judgment, there are many beautiful promises of restoration read; and Isaiah is one of the most wonderful books in the Bible; which is all my excuse for quoting it here:

Therefore thus saith the Lord God: Behold, I lay in Zion for a foundation a stone, a tried stone, a precious corner stone, a sure foundation; he that believeth shall not make haste.
And your covenant with death shall be disannulled, and your agreement with hell shall not stand. . .
Bread corn is bruised; because he will not [for]ever be threshing it, nor break it with the wheel of his cart, nor bruise it with his horsemen. This also cometh forth from the Lord of hosts, which is wonderful in counsel, and excellent in working.     from Is. 28:16-29

Lastly, yesterday my mother pointed out to me this truly wonderful summary, to be read after the passage in Matthew 23 where Jesus tells his disciples that of all the beautiful buildings of the temple in Jerusalem, not one stone will be left upon another:

“When the disciples heard the prophecy of the Savior, they showed him the temple, the venerated stones, and the sanctuaries. He responded to them, saying, There will not be two stones together. Verily this happened forty years after the ascension of our Lord. The Romans came, devastated the city, and demolished the temple, which remains thus to this day. One million and two hundred thousand Jewish men were killed by the sword. They were castigated by God’s wrath, and his damnation covered their faces.”

Thus we conclude that the Copts are actually preterist and postmillenial in their eschatology (as can be seen further by the Messianic promises from Isaiah being read together with the parables of the kingdom of heaven, and the prophecy in Daniel of the Ancient of Days being associated with Christ’s death and resurrection, and in general all the Messianic psalms, concerning both his humiliation and his exaltation, being brought together in this week); they have not worked this out in detail, and the people generally are uninformed on the subject. But those of us who have wandered into the heady pastures of Reformed postmillenial thought rejoice to see that the Copts are on the right track here as well. (In case you can’t tell, I will be happy to exposit on this at length if anybody asks. Or email me at my new address, on-the-dotted-line at hot mail dot com.)

This is the Pascha doxology. Every hour it is sung after the prophecy has been read, and before the psalm and gospel. The second stanza has a phrase added to it every day; this is the complete form, which is sung on Friday. It is repeated twelve times, antiphonally between the sides of the church, the pace and language (fast, slow, Arabic, Coptic, English) to be determined by the senior deacon. (All of these Pascha services, except for the memorial liturgy on Thursday, are prayed in the nave of the church, staying outside the sanctuary behind the iconostasis, and outside the deacons’ usual benches on the platform right in front of the iconostasis, in commemoration that our entrance into the Holy of Holies was only opened by Christ’s death, which is remembered on Friday.)

Kyrie eleison.
Thine is the power, the glory, the blessings, and the majesty forever, Amen:
                  O Emmanuel our God and our King.
Thine is the power, the glory, the blessings, and the majesty forever, Amen:
                  O my Lord Jesus Christ, my good Savior:
                  The Lord is my strength and my praise,
                   and has become my salvation.
Thine is the power, the glory, the blessings, and the majesty forever. Amen.

 Every hour has a prophetic reading, which ranges from the Old Testament stories of Creation and the establishment of the covenant with Abraham, to the covenant lawsuit passages in Isaiah, Jeremiah, Hosea, Amos, and the others, where God describes the sins of his people and the punishment they deserve, but also often speaks of the coming days when he will finally take their sins away, and they will be indeed a pure bride.

After the doxology, the psalm is sung first, very slowly (in the Coptic chants, the sadder the occasion the slower the chant – except for the great high feast day of Easter itself, when the chant gets slower than ever!) in Coptic by one of the deacons. When I was young and irreverent, I once timed that one vowel in this chant could last for 40 seconds; and Coptic has lots of vowels. Now I consider the time better spent in meditating on the verse, or in learning the Coptic letters and words. Here are some of the Psalm readings from yesterday and today; it is wonderful to see how many of the Psalms become Messianic when considered in this context:

He only is my rock and my salvation; he is my defence; I shall not be moved.
In God is my salvation and my glory; the rock of my strength, and my refuge, is in God.
         Ps. 62:6-7

Consider and hear me, O Lord my God; lighten mine eyes, lest I sleep the sleep of death. . .
But I have trusted in thy mercy; my heart shall rejoice in thy salvation.
        Ps. 13:3, 6

The Lord bringeth the counsel of the heathen to nought; he maketh the devices of the people of none effect.
The counsel of the Lord standeth for ever, the thoughts of his heart to all generations.
         Ps. 33:10-11

Plead my cause, and deliver me; quicken me according to thy word.
Salvation is far from the wicked, for they seek not thy statutes.
         Ps. 119:154-155

He delivered me from my strong enemy, and from them which hated me, for they were too strong for me. . .
He delivereth me from mine enemies: yea, thou liftest me up above those that rise up against me; thou hast delivered me from the violent man.
         Ps. 18:17, 48

Unto thee, O Lord, do I lift up my soul.
O my God, I trust in thee; let me not be ashamed, let not mine enemies triumph over me.
Yea, let none that wait on thee be ashamed; let them be ashamed which transgress without cause.
        Ps. 25:1-3

Then the Psalm and Gospel are read together, either in English or Arabic, still chanted, but in a much more efficient “reading” tone. The gospel readings are arranged so that everything between the entrance to Jerusalem and the Last Supper is read during Monday, Tuesday, and Wednesday. During these days, there is only one gospel reading per hour. These include the rebukes of the Pharisees, the last questions posed to Jesus and his authoritative answers (the source of John the Baptist’s authority, the tribute to Caesar, the resurrection of the dead brothers and their wife, the greatest commandment, and David’s calling his Son Lord), and the description of the last days [of Jerusalem, by my interpretation].

This is the concluding hymn, sung antiphonally between the north and south sides of the church, at the end of the morning prayers and of the evening prayers all week.

O King of peace, bestow thy peace upon us; make firm thy peace upon us; and forgive us our sins.
Kyrie eleison.

Disperse the enemies of the church, and fortify her stronghold, that she may not be shaken forever.
Kyrie eleison.

Emmanuel our God is now in our midst, with the glory of His Father and the Holy Spirit.
Kyrie eleison.

May He bless us, and purify our hearts, and heal the sickness of our souls and bodies.
Kyrie eleison.

We worship thee, O Christ, together with thy good Father and the Holy Spirit, for thou wast crucified, and saved us.
We cry out saying, Our Lord Jesus Christ, who was crucified on the cross, trample down Satan under our feet.
Kyrie eleison.

The is the response between the priest and the people said at the end of every canonical prayer hour (for convenience, all the day prayers are said in the morning, and all the evening prayers in the evening; the Copts are pragmatic, and recognize the necessity of going to work sometimes) before and after the exposition, a short summary of the Gospel reading for the hour.

In the name of the Trinity,
one in essence,
the Father and the Son
and the Holy Spirit:

O true light,
which enlightens
every man
who comes into the world:

Christ our Savior
has come and has born suffering,
that through His Passion
He may save us.

Let us glorify Him
and exalt His name,
for He has done us mercy
according to His great mercy.

I’ll throw in some more obscure Western hymns, too. This one was written by Venantius Honorius Fortunatus in 569 (he’s the author of one of the best Christmas songs ever, “Of the Father’s Love Begotten”), matched in the 1940 Episcopal hymnal with the tune Vexilla Regis, of Plainsong derivation.

The royal banners forward go,
The cross shines forth in mystic glow
Where he, as man, who gave man breath,
Now bows beneath the yoke of death.

Fulfilled is all that David told
In true prophetic song of old;
How God the nation’s King should be,
For God is reigning from the tree.

O tree of beauty, tree most fair,
Ordained those holy limbs to bear;
Gone is thy shame, each crimson’d bough
Proclaims the King of glory now.

Blest tree, whose chosen branches bore
The wealth that did the world restore,
The price of humankind to pay,
And spoil the spoiler of his prey.

To thee, eternal Three in One,
Let homage meet by all be done.
As by the cross thou dost restore,
So rule and guide us evermore.

Most of my memories of Christmas are shaped by Western traditions – carols, Christmas trees, decorations. But Easter I have primarily experienced through the Pascha (Passover) week rituals of the Coptic (Egyptian) Orthodox Church. I think Christmas is a one-day event, and easily lends itself to feasting and celebration, so even cultures as bare of tradition and ritual as American evangelicalism can do Christmas pretty decently. But Easter is different. Properly understood, it’s the culmination of forty days (or fifty, for the Copts) of fasting and preparation, and a week of reliving the last hours of Jesus’ life. It is the central event of Christendom, and indeed of all human history. One week dedicated to meditating on the events is not too much to spare. So, I’m going to post here some of the readings and hymns from the Coptic prayers of Pascha week. (If my internet connection improves tomorrow, I might be able to find the online recordings of the chants. You have to bear in mind that the Copts chant everything; if you’ve heard some Muslim prayers, it’s a similar musical style, but different, because we came first. ;)

(Flipping through the prayer book, so saturated with incense that it fills the room even now:)

The doxologies of Palm Sunday, sung before each Scripture reading (Hebrews, 1 Peter, Acts, and each of the Gospel accounts), accompanied by cymbals and triangle (and you have to picture the church decorated with woven palm leaves, and the children making camels and pyramids out of palm leaves, and the ladies wearing palm leaf crosses, and the priest’s usual inlaid cross replaced with an elaborate palm leaf creation):

He who sits upon the Cherubim, on the throne of his glory, sat upon a colt, and entered Jerusalem.

Hosanna in the highest. This is the King of Israel. Blessed is He who comes in the name of the Lord of Hosts.

Alleluia. Alleluia. Jesus Christ the Son of God entered into Jerusalem. Alleluia. Alleluia.

Sing aloud unto God our strength; make a joyful noise unto the God of Jacob. Take a psalm, and bring the timbrel, the pleasant harp with psaltery. Blow up the trumpet in the new moon, in the time appointed, on our solemn feast day.    Psalm 81:1-3

Hosanna in the highest. This is the King of Israel. Blessed is He who comes in the name of the Lord of Hosts.

Praise waiteth for thee, O God, in Sion; and to thee shall the vow be performed. O thou that hearest prayer, to thee shall all flesh come.    Psalm 65:1-2

He who sits above the Cherubim today appeared in Jerusalem, riding on a colt with great glory, and multitudes of angels surrounding Him.

The crowds spread garments on the road, and cut branches from the trees, shouting and singing: Hosanna to the Son of David.

For if the blood of bulls and of goats, and the ashes of a heifer sprinkling the unclean, sanctifieth to the purifying of the flesh, how much more shall the blood of Christ, who through the eternal Spirit offered himself without spot to God, purge your conscience from dead works to serve the living God? . . .

For Christ is not entered into the holy places made with hands, which are the figures of the true; but into heaven itself, now to appear in the presence of God for us: nor yet that he should offer himself often, as the high priest entereth into the holy place every year with the blood of others, for then must he often have suffered since the foundation of the world: but now once in the end of the ages hath he appeared to put away sin by the sacrifice of himself:

And as it is appointed unto men once to die, but after this the judgment, so Christ was once offered to bear the sins of many; and unto them that look for him shall he appear the second time without sin unto salvation.    Hebrews 9:13-14, 24-28

Today these sayings have been fulfilled, as told in the prophets and proverbs, as Zechariah prophesied about our Lord Jesus Christ.

And the Fraction Prayer, which changes for the different occasions in the church year:

O Lord, our Lord, as a wonder your name became upon the whole earth, for the greatness of your splendor is exalted above the heavens. Out of the mouths of babes and sucklings you have prepared praise. Prepare also, O Lord, our souls for praising You, singing to You, blessing You, serving You, worshipping You, glorifying You, giving thanks to You every day and every hour; that we may confess to You and cry out to You, O Holy Father who are in heaven: Our Father, which art in heaven. . .

(And I’ll just throw this out for the sake of some Protestants who think the Orthodox believe in salvation by works, and aren’t true Christians: read these things, read through their prayer books, and try to tell me that again. The whole Liturgy and Agbeya (prayers of the hours) are basically just verses rearranged as prayers.)

In my spare time reading today, I came across a good deal of controversy in conservative circles about Dinesh D’Souza’s new book, The Enemy at Home: The Cultural Left And Its Responsibility For 9/11, in which he argues that 9/11 happened because Muslims were justifiably outraged by the social liberalism which the US is spreading around the world. Judging by reviews, D’Souza suggests that American conservatives/traditionalists ought to form an alliance with Muslims and other traditionalist societies against the forces of liberalism, thus solving both the war on terror and the cultural war at the same time.

Like most of the conservative commentators, I’m rather stunned by this concept, but for different reasons. I’ll refer to Stanley Kurtz’s analysis at National Review Online as an example. He says,

“D’Souza tries to clear a path for an alliance of Muslim and Christian traditionalists by sympathetically explaining key differences between the two religions: ‘Unlike many Christians, who have multiple identities only one of which is that they happen to be Christian, Muslims typically regard their religion as central to both private and public identity, and consider all other affiliations as secondary or derivative.’ Good point. The lesson D’Souza seeks to draw here is that Christians ought to tolerate the somewhat broader religious boundaries of their sincerely traditionalist brethren in the Middle East. Yet doesn’t the tendency to subordinate all public and private identities to Islam suggest a reason why Islam and modernity are in tension to begin with?”

The problem is, D’Souza has drawn a strong dilemma, and Kurtz chooses the wrong horn of the dilemma. The answer is not, if we want liberty we have to separate private and public, religious and secular spheres. The answer is, we need the right religion, one which teaches conversion by persuasion, not violence, one which upholds individual rights rather than subordinating everything to a totalitarian religious leader (eg Iranian ayatollahs).

As long as we try to interact with Muslims by trying to persuade them that they can separate their religion from their daily activities and choices, we are bound to fail. Not only that, but as long as the American church continues to grasp at this rag of an excuse for incomplete obedience to Christ, we will continue to deserve the shame of abortion and sodomy flung like filth across our land.

True Christianity is not one among multiple identities. It should be the overwhelming, all-encompassing identity which subsumes all others. Only then will life have true meaning, instead of being “sound and fury, signifying nothing.” (For an eloquent and earthshaking statement of this old-new philosophy, see Peter Leithart’s new book, Against Christianity.) I am not a Christian on Sunday, and a medical student Monday-Friday, and a twenty-something girl on Saturday. I am a Christian, always, because the whole universe, and every minute of every day, belongs to my Lord Jesus, and everything I do ought to be subordinate to that. (Not saying it is, but that’s my failing, not my desire.)

This is the only true answer to Islam. We cannot fight a world-encompassing way of life and thought which centers every aspect of society around a false god by politely requesting its adherents to withdraw into a 1-in-7 mentality, thus matching the surrender of modern Christianity. The only response which is on the same level, which in the end will be stronger, is one which acknowledges that religion truly drives culture, politics, economics, and private life, and then gets down to living the true religion in that way.

Today was perfect (apart from a long and nerve-racking drive in on icy roads). Nothing much happened, and the attendings didn’t try to teach very much. Enough residents were gone to clinic that I got my own computer, and got to sit and knit and read medical blogs and Federal Vision websites. (This very esoteric tempest in the teapot of conservative Reformed theology is very confusing to me; I’m just concluding that I like what they say, when I come across a clearer exposition of their beliefs, and am surprised and horrified all over again; it’s like climbing into a cold pool very slowly.)

Somehow our family volunteered itself to sing a song in church sometime soon. This will be quite an innovation for our conservative Presbyterian church, which barely tolerates non-psalmodic hymnody and piano accompaniment. We’re going to sing a psalm, a capella, so that should be ok. Trick is, I don’t know how to sing. It’s really not fair that I love music, especially vocal music, and am completely incapable of carrying a tune. I can’t even tell whether my voice and the piano are matching, or not; let alone whether I’m in harmony with the rest of the family, when we haven’t got a piano. I think the tunes sound better when the intervals are slightly diminished, and a few sharps and flats are added, but the rest of the family disagrees. We’re negotiating a truce, where they will sing as loudly as I wish I could, and I will keep quiet in the background. This is where having lots of children in the family really helps.

I took a little notice of domestic events, and listened to Sean Hannity on the way home:
– How is it possible to convict Border Patrol agents for patrolling the border? This is one of the most tragic travesties of justice I’ve heard about in recent days.
– What makes Congress think that it has the authority to pass a resolution telling the President how to run the war? They should either withdraw funding, and be responsible for the consequences, or run for the job of Commander-in-chief and see if they can get a mandate, or else be quiet. Right now most of the senators are just dogs in the manger, trying to have their cake and eat it too: the pleasure and fame of grandstanding, without any actual responsibility.
– Speaking of usurping authority: Gov. Rick Perry’s unilateral decision to require the Gardasil vaccine for schoolgirls is objectionable on so many levels, as it tramples on the jurisdiction of both the legislature and parents. HPV is not in the same category as measles and diphtheria, which can be transmitted between very small children, and without any knowledge or choice on the part of the carrier or the recipient. HPV is primarily transmitted as the result of specific actions of individuals with some capacity to choose (however ill-exercised). You don’t require herd immunity for it. And in any case, some public discussion ought to be allowed.
– All the presidential candidates are very interesting characters, and this should be an exciting election season. But I’m not sure I can sustain interest, let alone passion, over a two-year long campaign. And I’m an ex-political junkie. I hate to think what the attitude of the general population is going to be by the time November 2008 gets here.
– Much as I object to his politics and her politics and character, the prospect of the first (potential) black or female president is fascinating. Somebody should push Condi Rice into the ring, and then we could do both at once, and I could even vote for her.
– The global warming police are coming out in force. On which subject see this eloquent speech by Michael Crichton, whose book State of Fear does a good job of combining thriller plotting with good science (and footnotes).

Last night Dr. Mark was called regarding a young man, who with his brother was shot in a crack house, apparently over a drug deal gone bad. This particular fellow got shot through the face and neck, fracturing at least one part of his mandible, and requiring repair and general exploration. His brother was unstable, and spent most of the night in the OR (I don’t know how that turned out), so our patient didn’t get to surgery until this afternoon.

He was a prime example of the law of inverse proportionality: the more useless a member of society is, the less likely they are to be seriously injured by any major trauma that happens to them. The bullet had managed to go through one mandible, straight through the root of the tongue, and out into the neck (not all the way out) without disrupting his airway, carotids, or major nerves. The trauma surgeons obviously had difficulty believing this, and got multiple CT scans of his neck. Even so, the exact injuries were not clear until Dr. Mark bravely pulled out all the gauze that had been packed around the ET tube to control the bleeding, and started poking around.

The patient was HIV positive. This is the first time I’ve scrubbed on a case where the patient was known to have HIV; I’ve been in Hep B and Hep C cases before, but not HIV. Everyone who helped to move the patient was meticulously gloved (unusual), and we all double-gloved for the surgery, and were very conscious of where the needles were. Dr. Mark was eager to avoid putting arch bars in, because those sharp wires would be just begging for someone to get stuck.

Some attendings encourage medical students not to scrub on cases where the patient is known to have either hepatitis or HIV, for two reasons: the medical student doesn’t really have any clinical responsibility, so they’re not obliged to be there; and medical students are most frequently stuck, because they’re standing with their hands in the field, between the surgeon and the scrub tech, and we don’t always know what we’re doing. Dr. Mark offered not to include me, but I didn’t take him up on it. If I want to do surgery, then viruses are an occupational hazard. God is in control; and the only thing to do is to use as many precautions as possible, and not worry about it after that. Also, I’ve been thinking (especially around Dr. Mark, arguing about the morality of war): my worldview includes many dangerous precepts, but I haven’t had to act on any of them yet. For example, it’s remarkably convenient to be a proponent of wars in general, and this war in particular, and also to say that it’s wrong for women to be in the military; that’s really not why I hold those positions, but it’s undeniably convenient. This surgery is one of the first places where I can do something dangerous because I think it’s right. A small step, but in the right direction.

Dr. Mark let me try to imitate his meticulous suturing techniques on the entrance wound. Then after he’d finished sewing the tongue back together and picking fragments of bone out of the mouth, he let me make an incision right over where the bullet was lodged under the skin of the neck, and fish it out with a hemostat, and sew that incision, too. Great opportunities; I discovered tha three months of not practicing has definitely eroded my suturing abilities. There are still five months till I’m a surgical intern; I’m going to be all thumbs again by then.

The conversation during the case involved an unusual kind of pimping: Rather than, “What artery is here?” or “What nerve innervates this area?” we somehow landed on the trial and execution of Michael Servetus. I think I unwisely teased Dr. Mark by telling him that my brother had just purchased a pistol, and we were all very proud of it. This exhibition of violence by Christians (Presbyterians, at that) led him to Zwingli having died in battle, and thus naturally to Servetus being burned for a heretic in Calvinist Geneva, and questions like, “Who was Guillame Carrel?” and “Who was Sebastian Castelio?” I unsuccessfully attempted to defend Calvin’s personal involvement in it, and ended up having to retreat with a promise to research the question over the weekend. The nurses were vastly entertained.

I’ve been saying this for a couple of months, but it finally made sense to me a few days ago: It doesn’t do any good to worry about the Match. It’s very simple: If God wants me to be at the place I like best, it doesn’t matter how I rank them, or how they rank me, it will work out. And if he doesn’t want me there, it doesn’t matter whether I have great grades and rank them first, it won’t happen. And all the possibilities from there on come out the same way. I can’t exactly hope to finick my Match list to arrive at a result contrary to God’s plan; and neither can any of the programs I’m applying to. So what if he obviously isn’t going to explain the plan to me until the middle of March?

So Alice would you please stop running probability combinations in your mind of how things will turn out in each of the five different ways you could arrange your list? Stop already!

Reading Winston Churchill’s history of World War 2 made me do two imprudent things: agree to play Risk with my brother, and offer to play the world domination form of it (rather than the more limited mission format). This led to three straight hours of four of us grouped around a board of plastic figures, yelling insults at each other, and impersonating, by turns, Robert E. Lee, Hitler (because the person with the grey pieces was taking over Europe), Stonewall Jackson, Stalin, Winston Churchill, General MacArthur, and General Long (I think he was in the Revolutionary War; it took him forever to make decisions). The game came to its usual conclusion: after several turns, everyone decided that, whatever else happened, they definitely wanted their oldest sister to lose, and ganged up on me. I offered to surrender a couple of times, when I had been reduced to eight countries and nine men, but since no one could agree on who would receive my countries and my cards, they wouldn’t let me surrender. Our mother tried to feed us lunch in the middle, and didn’t understand the storm that greeted her efforts to disrupt my last-bid attempt to control Asia.

Which is why we only play Risk every five months. That’s how long it takes me to forget how frustrating it is to lose, and how unlikely it is that I’ll ever control three continents before everyone decides to ally against me.

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