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.

This carol’s beautiful words are thrilling even without the music. Which is just as well, since it’s from the 4-CD set “A Celebration of Christmas: Carols through the Ages” by the Alfred Deller Consort, which I can’t find on the web anywhere. If you find it, don’t let it slip away. It has dozens of lovely songs, many English carols as well as medieval Christmas motets and chants.

People, Look East

People, look East, the time is near
Of the crowning of the year.
Make your house fair as you are able,
Trim the hearth, and set the table.
People, look East, and sing today:
Love, the Guest, is on His way.

Furrows, be glad, though earth is bare,
One more seed is planted there:
Give up your strength the seed to nourish,
That in course the flower may flourish.
People, look East, and sing today:
Love, the Rose, is on His way.

Birds, though ye long have ceased to build,
Guard the nest that must be filled.
Even the hour when wings are frozen,
He for fledging-time has chosen.
People, look East, and sing today:
Love, the Bird, is on His way.

Stars, keep the watch. When night is dim,
One more light the bowl shall brim,
Shining beyond the frosty weather,
Bright as sun and moon together.
People, look East, and sing today:
Love, the Star, is on His way.

Angels, announce to man and beast
Him who cometh from the East.
Set every peak and valley humming
With the word, the Lord is coming.
People, look East, and sing today:
Love, the Lord, is on His way.

Today we tend to think of the West as the location of happiness and salvation. The “West” is the stronghold of freedom and democracy. In Celtic mythology, the Blessed Islands were in the West, as well as Avalon in Arthurian legend, and Atlantis. In Tolkien’s mythology, the men of Westernesse coming from Numenor (a version of Atlantis) were the heroes, and the elves longed to return to their home in the western sea.

But in the Bible, the East is significantly associated with God’s presence. The gate of the Garden of Eden faced the east, where God placed the cherubim with a flaming sword after Adam and Eve were cast out because of their sin. Isaiah 63, referring to Christ, says, “Who is this that cometh from Edom [east of Jerusalem], with dyed garments from Bozrah? this that is glorious in his apparel, travelling in the greatness of his strength? I that speak in righteousness, mighty to save.” And when Jesus, who reconciled us to God, ascended to heaven from the Mount of Olives, which is on the east side of Jerusalem and the Temple Mount, the angels promised his disciples, “This same Jesus, which is taken up from you into heaven, shall so come in like manner as ye have seen him go into heaven.” (Acts 1:11) The early church interpreted this to mean that Christ would return from the east, where he ascended; so Orthodox churches are built facing the east, and early Christians used to be buried facing the East, so that they would be ready for the Second Coming.

People, look East, and sing today:
Love, the Lord, is on His way.

This is one of my absolutely all-time favorite songs. The words were written in 18th century America, but did not have a tune until they were set to music by Elizabeth Poston in the last century. The melody is light and haunting. It’s often sung in the King’s College Festival of Nine Lessons and Carols. You can listen to parts of this song and some of the other carols I’ve posted here.

Jesus Christ the Apple Tree

The tree of life my soul hath seen,
Laden with fruit, and always green:
The trees of nature fruitless be
Compared with Christ the apple tree.

His beauty doth all things excel:
By faith I know, but ne’er can tell
The glory which I now can see
In Jesus Christ the apple tree.

For happiness I long have sought,
And pleasure dearly I have bought:
I missed of all; but now I see
‘Tis found in Christ the apple tree.

I’m weary with my former toil,
Here I will sit and rest awhile:
Under the shadow I will be,
Of Jesus Christ the apple tree.

This fruit doth make my soul to thrive,
It keeps my dying faith alive:
Which makes my soul in haste to be
With Jesus Christ the apple tree.

Progressing to a higher level of poetry, back to Elizabethan England: John Donne’s Holy Sonnet XV, which is an amazing compression of Trinitarian and incarnational theology into a tight packet of carefully metered verse. (The apostrophes indicate elided syllables.)

Wilt thou love God, as he thee! then digest,
My Soul, this wholesome meditation,
How God the Spirit, by Angels waited on
In heaven, doth make his Temple in thy breast.
The Father having begot a Son most blest,
And still begetting, (for he ne’r begun)
Hath deigned to choose thee by adoption,
Coheir to’his glory,’and Sabbath’s endless rest.
And as a robb’d man, which by search doth find
His stol’n stuff sold, must lose or buy’it again:
The Son of glory came down, and was slain,
Us whom he’had made, and Satan stol’n, to unbind.
‘Twas much, that man was made like God before,
But, that God should be made like man, much more.

Turning from medieval times to relatively recent history: two Christmas poems by G. K. Chesterton. (If I run out of Christmas poems, I’ll just come back and start typing my entire book of Chesterton’s poems in here. . .)


If the stars fell, night’s nameless dreams
Of bliss and blasphemy came true,
If skies were green and snow were gold,
And you loved me as I love you;

O long light hands and curled brown hair,
And eyes where sits a naked soul;
Dare I even then draw near and burn
My fingers in the aureole?

Yes, in the one wise foolish hour
God gives this strange strength to a man.
He can demand, though not deserve,
Where ask he cannot, seize he can.

But once the blood’s wild wedding o’er,
Were not dread his, half dark desire,
To see the Christ-child in the cot,
The Virgin Mary by the fire?
A Christmas Carol

The Christ-child lay on Mary’s lap,
His hair was like a light.
(O weary, weary were the world,
BUt here is all aright.)

The Christ-child lay on Mary’s breast,
His hair was like a star.
(O stern and cunning are the kings,
But here the true hearts are.)

The Christ-child lay on Mary’s heart,
His hair was like a fire.
(O weary, weary is the world,
But here the world’s desire.)

The Christ-child stood at Mary’s knee,
His hair was like a crown,
And all the flowers looked up at him,
And all the stars looked down.

This carol, although written in the 1500s, became popular recently. It’s an enchanting mixture of the Song of Songs and the Christmas story.

Tomorrow shall be my dancing day,
I would my true love did so chance
To see the legend of my play,
To call my true love to my dance:
           Sing, O my love, my love,
           This have I done for my true love.

Then was I born of a Virgin pure,
Of her I took fleshly substance;
Thus was I knit to man’s nature,
To call my true love to my dance:
          Sing, O my love, my love,
          This have I done for my true love.

In a manger laid and wrapped I was,
So very poor, this was my chance,
Betwixt an ox and a silly poor ass,
To call my true love to my dance:
          Sing, O my love, my love,
          This have I done for my true love.

Then afterwards baptized I was;
The Holy Ghost on me did glance,
My Father’s voice heard from above,
To call my true love to my dance:
          Sing, O my love, my love,
          This have I done for my true love.

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