My Unusual Thanksgiving List

I just drove back from Knoxville after a wonderful Thanksgiving celebration with all 16 of our crazy clan. The entire drive back I had my WOW Hymns from like the 90’s going. As I sang along and praised God on the way home I couldn’t help but remember how different this drive was just a few years ago. You look forward to going home for so long, then your there for 24-48 hours and then have to turn around and go back. Those drives back could be SOOOOO long and lonely and very depressing. But not this drive. Not because it isn’t just as sad to be leaving my family again, but because my focus was on the God who gave me that family. I was reminded as I drove of the blessing of pain and suffering. Hear me out. 

I used to live just down the street from my older sister and her 2 children. We had way too much fun together those two years and were very spoiled. Moving away from them was one of the hardest things I’ve ever done and I still miss them almost daily. Possibly because I have a placemat with all of their faces all over it sitting on the table where I eat every day. I dearly miss them and I could not wait to see them this past weekend. All that longing and sadness about missing them made it that much more special when both children ran to greet me and jump into my arms as soon as I arrived. Would their embrace have been special if I had not been missing them? Of course, but not nearly to the extent that it was. 

Here’s another real life example. Modern day Leprosy (or Hansen’s Disease) is a bacteria that affects the nerves and skins and mucus membranes. Part (but certainly not all) of the problem in this disease is numbness. Similar to someone with bad diabetes, small nerves in the feet no longer transmit pain signals. Their feet can no longer feel pain. Sounds like a good thing, right? Actually, this is very dangerous. Pain serves as a warning sign to the body that something is wrong. For example, that rock in your shoe is supposed to hurt every time you step on it to remind you to take it out. But if you can’t feel the rock or the pain it brings you just leave it there. And, after some time that rock causes a sore on your foot and then it gets infected. 

On a much larger scale than a rock in our shoe, God uses painful experiences as warnings for us, or as a way to allow us to more fully experience the good. This gets at the heart of the question ‘why does God allow bad things to happen’. Think with me for a moment, and go down deep with me. If we were perfect and sin never entered in to the world, how could we know the mercy of God, or the grace of God? He would not need to be merciful because we would not sin, and He would not need to show grace because we would not require it to be in fellowship with Him. Yes, we may know that He loves us, but could we really know the depth of that love? Our ability to know the complexity of God is already limited by our finite minds, yet not knowing sin would severely limit our ability to know multiple attributes of the person of God. 

It is because of my sin, the utter heinousness of it and the fact that there is no good thing in me apart from God that I can know His love for me to be so unfathomable, amazing, and beautiful! Seeing my sin for what it is allows me to see His grace and mercy that reaches to the heavens. I could not know God to the capacity that I do if he had not allowed sin in this world. Likewise, if I did not know the pain and heartache of losing a patient, a friend or a family member could I know the joy of my time with them to the extent that I do? My pastor always says we are all individually going through hard times now, just came out of a hard time, or headed into a hard time. That is part of this life the way that God intends it. I cannot tell you the specifics of why God has you going through the specific hard time you are in, but I firmly believe and trust that if we fix our eyes on Him through it all that He will not only carry us through the hard time, but also allow us to know Him more intimately that we could have known Him before. I heard once that each stumbling block can also be a stepping stone. When the hard times come, and they will, I encourage us all to fix our eyes on the One who we trust through it all. As muscles only get stronger if you cause them to tear (microtears) by over using them, we too will become stronger and better equipped for this road ahead as we allow God to use hard times to make us more like Him. 

So, as strange as it is, this season I am thanking God for the pain, the loneliness, the sadness. Because through it He has allowed me to know Him, and there is no greater gift!

A Life Poured-out

In the wake of all that happened in my life recently as described by my latest post, I had asked for prayers from many people. I wanted to share with you how God has answered those prayers even today. 

This past weekend I had the privilege of being at my home church in Powell. To be honest it was difficult to concentrate as I was basking in the wonderful feeling of just being home. Sitting under the pastor that God has used to speak Truth to me since I was first able to Hear, I heard God once again. He was preaching from 2 Corinthians 5:11-17 on “The motivation for a poured-out life.” “Therefore I urge you brothers by the mercies of God to present your bodies a living and holy sacrifice acceptable to God, which is your spiritual service of worship” (Romans 12:1). “Or do you not know that your body is a temple of the Holy Spirit who is in you, whom you have from God, and you are not your own? For you have been bought with a price, therefore glorify God in your body” (1 Corinthians 6:19-10). I was in Knoxville that Sunday on my way to an interview for a sports medicine fellowship. I left church realizing I had not been living a poured-out life, but seriously hard core living for myself. Residency is not fun, but that does not give me an excuse to make it all about me. 

I knew I would be driving A LOT over the next few days so I downloaded an audiobook. This is where God seriously began bringing me back to Him. For those of you who know me, you know that I love music. Typically music is all I need to get throughs hours and hours of travel. But I came across a book I had been recommended and decided this drive was a perfect time to “get it in.” The book is entitled “Seeking Allah, Finding Jesus.” The life of Nabeel Qureshi was played out before me and caused me to have several moments of praising our God as I drove. I highly recommend this book or audiobook for anyone reading. After hearing how this devout Muslim was wooed and sought after by God to bring him to Himself, and how he then left literally everything to serve Him, I couldn’t help by be inspired. Essentially I came away with these truths reignited like a flame in me: 

1-   God, the True, Living God- He is everything! Knowing Him, serving Him is the highest honor and greatest treasure a life could have. He is truly worth any price.

2-   It (life, residency, whatever) is NOT about me. In the moments after this former Muslim  told his family he had decided to follow Jesus as Lord and not Allah, he describes the anguish he felt at losing his family, causing them shame and extreme heart ache despite all they had done for him. In the midst of it he looks up and sees a man walking in the darkness and realizes that this man does not have Jesus. In all his heart ache he was overwhelmed by the need this man had for a Savior. A Savior that he knew. It is then that he realizes that life is no longer about him. He left everything he had and spent his remaining years in ministry.

Yet yesterday as I came into work to cover seemingly the single worst shift of pediatric residency all I could do all day was complain. All the little things that did not go my way and all the times I felt like I was being used and unappreciated. It was all building up and I was harsh to some people. On one of my trips back up from the ED admitting a kid I just started praying, “Lord, I just can’t do it. I can’t be nice when I’m this tired, and I’m pushed to the edge over and over and over. I don’t have it in me. I’m so over this” In His mercy and grace He changed my heart even in the middle of my shift. Granted it was over 24 hours long. By the end of the shift, by His grace, my attitude had been fixed. When I left this morning I put one of my favorite songs on repeat, and as I pulled into my apartment these words broke through my thoughts, “If you gave your life to love them, so will I. Like you would again 100 billion times. But what measure could amount to your desire. You’re the One who never leaves the one behind” (So Will I, Hillsong). And that was it. I surrender. 

Yes, Lord I do want to be poured out, even here. Yes, even if it means always being the one who gets pulled to cover for others. Yes, even when it means staying extra-long, being extra tired, and going unnoticed. I want to be a life poured-out. Please God, allow me the privilege of serving you here, now. Because the extra shifts, extra hours, and extra energy are not for them, it’s all for you. And you are more than worth it! Forgive me, oh God, for being so fixated on myself that I failed to represent you well. Thank you for allowing me to hear your voice again and feel your joy and peace. Give me the grace, the strength, the joy, and the love to keep going joyfully in the midst of these trials. You are worth it. You are enough. 

Everything for life and godliness

Excuse me for a minute while my heart bleeds a little. Sometimes life is hard and it hurts. I’m going to be honest I have let the wind and the waves take over the past few week. But God has gently reminded me that even in the midst of the storm He is there. And not only is He there but He is using the storm to teach me and draw me closer to Him. The point of the storm is not to survive- it’s to meet the savior. 

I’m going to be really sore tomorrow, and in the worst way possible. Not because of a great workout, but because I had to crack a kid’s chest today to keep his heart beating. I did it all right. I got the intraosseous line in on my first try and it worked beautifully. I did chest compressions at the right depth with good recoil and at the right rate. We did it all: the Epinephrine, the ventilator, the lines. Yet at the end of it I stood there listening to a mom try to comfort her son over a phone call as his heart was stopping. I did everything I could and yet his heart stopped. I wasn’t enough. It hurt deeply and yet I realize the sting of sin even in myself in that moment. Why wasn’t I good enough to save him? What did I miss? I have to be better. But it’s not about me. It never is, and yet I try to make it such. The God of life, the Creator who put the breath into the lungs of this child is the only One with the authority to take that very breath from him. And even when he chooses to do so, He is still good. 

To say this past month has been hard would be a major understatement. Before this month a total of 2 of my patient’s had ever passed away. Today was the 5^thin the past 30 days. We have all heard the stories. Those tragic ones where someone wakes up one morning like it’s just another day without a care in the world but then something happens that changes their life forever. Just another weekend, another day at school, another tail gate. It can be very difficult to see and open your heart to become part of those stories in their final chapter.  

How are you supposed to handle being in those final chapters and the ends that they bring? And what about when it’s not just one? What if it’s 5? How do you keep getting up after inadequate sleep and going back into the fire to take care of all the other lives that are not in their final chapter (or at least you really hope not)? What do you do when you get home from all of this after you have kept yourself from breaking all day and there is no one to catch your fall, no shoulder to cry on? What do you do when it’s just you and God and you’re breaking and you can barely utter praise because it just comes out as tears; when your prayers end up being silent sobs on behalf of so many others and you can’t even utter words? 

The worst part of it all, is that as I lay in bed last night contemplating the weight of the world I was trying to carry I finally heard His voice. And it wasn’t peace at first but the bitter sting of conviction. In all my sorrow and stress this month I had tried to put my head down and plow through. I had longed for a companion to vent to and cry to and fall into, a companion other than Christ. I had made all of it about me. How tired I was, how sad and lonely I was, how hard I was working. I had been bowing to the god of self and comfort  and looking to friends and others for support and affirmation instead of standing firm on the Rock. I chose to wallow in my hard times instead of using them to make me more Christ-like. 

Today I came across this quote, "If I complain about the difficult circumstances of my life, I impugn the sovereignty and goodness of God, and tempt my listener to do the same. In this way, my sin 'metastasizes' into the heart of another person." (Jerry Bridges in Respectable Sins). And so I apologize for complaining to you all who have read this thus far. But the point I am trying to make is that even in these circumstances, God is good and has a great and wonderful purpose. Here is what God has reminded me of this week and how He has grown my faith in Him, and made me a better physician. 

It doesn’t matter what your occupation is, what ministry you are involved in, where you are in life, God is the prize. It seems basic but that’s what I need right now. If we are not seeking Him, we are missing it and failing, period. Yes, we do have everything for life and godliness (2 Peter 1:3a), but it is only through the knowledge of Him (2 Peter 1:3b). With the Holy Spirit in us, as we set our faces towards Him and meditate on His word, this is where our strength, peace, rest, hope, joy and love come from. “How blessed is the man who does not walk in the counsel of the wicked, Nor stand in the path of sinners, Nor sit in the seat of scoffers! But his delight is in the law of the LORD, And in His law he meditates day and night. He will be like a tree firmlyplanted by streams of water, Which yields its fruit in its season And its leaf does not wither; And in whatever he does, he prospers (Psalm 1:1-3).” Meditating on God and His word, that is where success lies. Studying for boards, studying up on my patient’s disease, rest, food, it’s all important and a good use of my time. But, if I am not in the Word (and not just reading to read, but contemplating, listening and obeying) then I have missed it. It doesn’t matter if I am the best doctor or pass boards with flying colors. If I have missed God then my life is wasted and my time here and now is wasted. “Seek ye first the kingdom of God and His righteousness . . . and (then) all these things will be added to you” Matthew 6:33. Every day anew we must surrender to Him and seek His face and He will be our strength for whatever may come that day. One day at a time, or even one hour at a time, we must keep our eyes on Him. 

Here we go again . . .

You know that moment when a feeling just comes over you to go talk to someone? You may or may not know why or even what you’re supposed to say but you know you’re supposed to go. That happened to me today.  Thankfully, I listened and went. But just a few days ago I’m not sure that I would’ve listened and that scared me a little bit.

It’s no secret residents and physicians alike (as well as nurses and others I’m sure) struggle with burnout. That place where you’ve been working so hard for so long. Things seem the same and you start feeling really underappreciated and maybe even used. We all get there, but how do we get out? In my short time as a resident, it seems this is a never ending cycle. Happy to be there and joyful in the midst of all  the work, tired but still okay, more tired but hanging on, and then nope, I’m done. It’s not like this isn’t a rewarding job. Helping make children better is almost always rewarding as is helping parents understand pathophysiology of what’s going on with their child. But when the medicine you are practicing is not your favorite, or you really have to study for it to keep up, or the patient’s and families are extra difficult and you just need some sleep, it’s gets tough.

My problem last week was that I shifted my focus from my patient’s, and ultimately from God to myself. I am so tied, I have worked so much, I deserve a break. Why aren’t my colleges stepping up to help ME, or why are they asking ME to help don’t they know how exhausted I am? Then my focus is more on how fast can I see all my patient’s and get out of there. Granted, once I know I’ve covered everything and they are ok. But then I’m not listening to those needs that they may not be sharing, or fears they don’t want to say out loud. I’m not listening to the Spirit in me telling me there’s more going on and I need to sit and wait and listen. And when I’m so focused on me, I don’t take care of myself.  Because all I want to do is go home and watch Netflix. I don’t want to cook, or clean, or read up on my patient’s disease process or workout. And in doing so I make myself more tired and feel worse overall. Thus is the cycle of burnout. At least for me. Sometimes starting a new rotation helps, but when burnout rares it’s ugly head early in a month’s rotation, you can’t just wait until your next rotation or vacation to get over it.

I kept wishing someone would just tell me I was doing a good job, that all this work actually meant something and wasn’t just marking time until I finished residency.  Does anyone see that I’m’ working myself to exhaustion here? I was in the middle of hematology and oncology month. A time when you really really need to not be focused on yourself, because these kids have cancer.  At least most of them do. So, when I couldn’t just pick myself up by my boot straps I just got angry at myself for being so weak and selfish in such a situation. I knew I should be there for these families and patients, but I couldn’t be there like they needed me. Why can’t I be a good doctor and put myself aside and selflessly love?

But thanks be to God that He does not leave us in our sin. I was lying in bed one night and as I began praying before falling asleep the thought came “why are you not on your knees?” In the past I had set aside a part of my closet as a place to do just that. But over the past month or so I decided I could fall asleep praying instead of taking the time to get on my knees and really sit at His feet. But that night I found myself lying there trying to pray over a family who just heard that awful news that their child has cancer, and I couldn’t connect with only One who could actually do something about it.

So, I climbed out of my warm bed and got on my knees. “Lord, I can’t do this. I’m not strong enough, and I’m way too prideful.” Thankfully, the Lord heard my prayers for forgiveness and humility. In spite of my sin, He allowed me into His presence to bring this family before Him. The next morning again, on my knees, “You are God, please put me in my place. I can’t do this.”  The last few days, by God’s grace He has made me get on my knees before Him. I have been listening to podcasts by John Piper afterward while I get ready in the morning. The Lord in His grace has used this to reshape my perspective. “You are not your own, for you were bought at a price, therefore glorify God in your body” (1 Cor 6:20). “Walk by the Spirit, and you will not gratify the desires of the flesh” (Galatians 5:16). “For if we live by the Spirit, let us also walk by the Spirit” (Gal 5:25). “Reckon yourselves dead unto sin and alive unto God” (Romans 6:11). Once my perspective changed, the past few days I have felt the Spirit working in me and my entire outlook has changed. I want to help in anyway even when I’m tired or hungry or late. I want to go out of my way to make someone else feel appreciated even though it’s inconvenient. I want to be kind and gentle to nurses even when they ask me questions I have already answered.

Yes, I work a lot, and I work hard. But, I work hard for the glory of God. As long as He is glorified I need no other recognition or thanks or gratifying outcome. Even when I’m tired and hungry and just over it, He still deserves all that I have. But He is also my supply. That’s what He has impressed upon me this week. When I walk without Him, of course I burnout because I cannot do it. I am not enough. But when I walk in the Spirit, I have new desires. I don’t mind taking care of an entire team of patient’s on my own and having an extra consult and admission. I don’t mind going back to sit with a family and explain things in detail even though it will make me late getting home and I’m already hungry. In fact it’s almost as if I’m a new person when His Spirit is working in me(ok, duh that’s the point). When those thoughts of anger or pride come, I have ammunition with which to fight them off. Though I still need to fight them off all day, I cannot tell you the difference it has made in me the past few days. And then today, as I was trying to leave the hospital in a hurry I had this overwhelming feeling that I needed to go back and talk to this family I had never meet. Their child had just been diagnosed with cancer and not a great one at that. The outcome did not look good and I could only imagine the overwhelming emotions flooding their minds. Today was my last day on this service. I won’t be taking care of this child and at the time he was just a name on our team list. But I had to go back.

I wrapped up everything else and headed back to his room. As I approached I heard voices inside and considered aborting the mission. But I walked in and saw a normal appearing family. All their faces set on me as if I had significant news to bring.  I proceeded to tell them who I was and that I was praying for them. We had a great conversation about how God was still in control even in their situation. The looks on their faces made it all worth it. As I left the hospital today I knew that not only was God gracious enough to bring me back to Himself, but He was showing Himself gracious to that family in the midst of their storm. It is an incredibly humbling thing to be used of God in such a way. And just like that I can say I am no long burnt out. At least for the time being. “For it is by the grace of God that I am what I am, but His grace towards me was not in vain but I labored more abundantly than they all, yet not I but the grace of God in me” (1Cor 15:10). I pray that the second half of this verse would be true of me someday, by His grace.