A Simple Question

    Three of our patients died yesterday. Two of them we have been working with for quite a while. They were all extremely sick, but at least the two for a while improved and we thought that just maybe they would get better and go home someday. But this weekend they both worsened for unknown reasons. I literally threw everything at them that I could think. And briefly one of them looked a little better. But, in the end the Lord took them home. He answered our prayers for healing, but wow, does it hurt. The worst part, or maybe a blessing, was that I wasn’t there when all of this happened. I had gone to see some patients at an orphanage 3 hours away. I left my team and I wasn’t there when the family I have walked with for almost 4 weeks lost their son who I have come to love dearly. For those of you who have lost loves ones from illness or injury, please know that we hurt with you too. 

 

    A few days ago I walked into the NICU and found my team doing CPR on an infant. I asked what had happened and they said one of the nurses just noticed the baby was not breathing while lying in her isolette and so they pulled her out and started CPR. No one knows what happened or when or how long she had not been breathing. By the time I arrived they had already given 8 doses of epinephrine, bicarbonate, and calcium gluconate to try to restart the heart but none of it was working. My team looked at me for answers but I had none. And I knew that based on how long they had been doing CPR without improvement that this baby was already gone. So, I told them to try one last dose of epinephrine and go for one more round of CPR. I don’t like making those calls or telling my team when to stop life sustaining CPR. When that cycle finished I listened for a heartbeat but couldn’t hear one. I tried feeling for a pulse but there was none. The baby was so small that every tiny movement of my stethoscope made me think that just maybe there was a heartbeat. So, I listened longer than usual trying desperately to hear what wasn’t there. In that moment all I could think was that this couldn’t be happening. She was just alive this morning. Did her heart really stop or is my mind playing tricks on me? I can’t make a call like this unless I’m 100% sure. So, I had another doctor listen, and a third. There was no heartbeat. But, we all took our time and tried to hear something. Then we all agreed that the heart had stopped and she was gone. 

 

    Why do we second guess ourselves with something so simple. Is there a heartbeat or not? Because that is a question you cannot afford to answer incorrectly. As I lay in bed that night a day after this infant passed away I was contemplating all of our really sick kids. Wondering if we were actually helping or causing harm. Of all my kids on ventilators this trip (9) only three have been successfully taken off the ventilator alive and two of the three are not doing well. As I lay there trying to sleep I was plagued by all the details and searching for answers. My soul ached for the deepest things in life. Did God really send me here, or was it my selfish desire to return to Africa and go on safari? Why would He send me, when I am not helping anything but just prolonging the inevitable? Does God really see what’s going on with these kids and their families? Why? Is there really hope for them? Is there even truly, honestly a God? 

 

    A question that seems so simple. Is there a heartbeat? Is there a God? Questions that I know the answers to, but feel the overwhelming weight of them. While to the one question I was trying desperately to find a reason to say there was hope, the other question is the reason I have hope. That doesn’t mean I don’t feel the weight of each loss. Rather it means I CAN feel that weight with the families, I CAN share in their burdens because I have a place to take them and lay them down. I don’t have to become hard and cenacle in order to continue facing death after death. I can allow myself to feel and be sad and vulnerable because Someone else is holding me. 

 

    We all go through times in life that just take the breath out of us. Things so hard we wish we could wake up from the nightmare. Things we never could imagine. They beg us to consider the deeper, simple things in life that give roots and anchor everything else. There either is a God or there isn’t. And if there isn’t and 10/10 people die then I am fighting a losing battle every day of my life (as are you). But, if there really is a God, a higher being that gives purpose and meaning to life then there is hope to be found. For each of us may we stop and consider the weight and implications of such a question. Does it affect our everyday lives? Do we live as if there is a God or not? 

 

    The crazy thing is that deep down we all know the answer to this question. Romans 1 tells us that creation makes it evident that there is a Creator. And the internal moral compass that seems to transcend generations, cultures, and continents also points to a Higher Authority. C.S. Lewis dives into this quite well in his book “Mere Christianity” which I highly recommend. But if there is this Higher Being why is there death and why do some kids die from congenital anomalies and others live full healthy lives? Well, I’m not God and I don’t have all the answers, but I can tell you that is not how God intended this world to be. He made it perfect (Genesis 1). But He also gave rules and gave us the ability to choose whether we were going to follow them or not. He didn’t make us robots. So we chose what ‘feels good’ and what we want, which is to not follow His rules. And now we suffer the consequences of that choice. Romans 3:23 tells us that we all fall short. All of us, including me and you. Romans 5 tells us that we are all actually under a curse because of sin and even all the good things we do or all the children I ‘save’ with medicine, none of it counts because I am still under the curse. Jesus tells us in Matthew that the standard is perfection, not only in action but even perfection in our motivations. And that is something I will absolutely NEVER be able to achieve. Not even in a single day let alone my entire life. It seems hopeless, but I said there was hope, right? The mind blowing thing, is that this same God who ‘breathed out the stars and calls them by name’ (Ps 33:6) also became a man (John 1) lived a perfect life and then died to pay for my sin and your sin (John 14:6, Romans 5, John 3:16). “But He was pierced because of our rebellion, crushed because of our sin; the punishment of our peace was upon Him, and by his wounds we are healed. We all like sheep have turned our own way; and the Lord has laid on Him the sin of us all” (Is 53:5-6).

 

    Jesus Christ was not only perfect in action and thought, but He also felt pain and hurt and sadness just as we do. Hebrews 4:15 tells us that He was tempted as we are in every way, but still remained without sin. And because of this, He alone understands what we are going through, because He Himself has felt it and He overcame! Now He can pay for all of our sins and settle our debt with God (romans 3:25, Hebrews 2:17, 1 John 2:2). But, this hope, this grace, this gift is only for those who receive it (Mark 4:16, 10:15). Acts 3:19 tell us to repent of our sins (agree with God that we are wrong in what we are doing, saying and thinking), turn from them (make effort to stop living for ourselves) and turn to God, then our sins will be wiped out! Romans 10:9 “Declare with your mouth that Jesus is Lord and believe in your heart that God raised Him from the dead and you will be saved.” You see the hope is found not only in that there is a way to God, but that it is not dependent on us, at all. It is not about us. Ephesians 2:8-9 “For it is by grace that you are saved through faith and not of yourselves, it is a gift of God. Not of works least anyone should boast.” Grace saves us, and grace keeps us secure. Now, here’s the kicker: because Jesus lived a perfect life, died on the cross for us and was raised on the third day (1 Corinthians 15:3-4), He not only paid the penalty for our sins, but He DEFEATED DEATH and SIN! 

 

    “But when this perishable (us humans with perishable bodies) puts on the imperishable (eternal life), and this mortal puts on immortality, then will come about the saying that is written: “DEATH HAS BEEN SWALLOWED UP in victory. WHERE, O DEATH, IS YOUR VICTORY? WHERE, O DEATH, IS YOUR STING?” The sting of death is sin, and the power of sin is the law; but thanks be to God, who gives us the victory through our Lord Jesus Christ. Therefore, my beloved brothers and sisters, be firm, immovable, always excelling in the work of the Lord, knowing that your labor is not in vain in the Lord.” (1 Corinthians 15: 54-58)

 

    This world is messed up. Little innocent babies sometimes are born into situations and circumstances where they suffer and die for what seems like no reason. People are sometimes evil, including myself. We do really horrible things to other people sometimes. There is so much hate and pride and selfishness. If there is no God . . . there is no hope. Yet one of my favorite phrases in all the Bible is, “But God” . . . He took the sting of death and it’s power away when He died on the cross and rose again.

 

    May you be encouraged today that even in the hard times when there is true reason to be hurt, sad, lonely, angry, overwhelmed, devastated, exhausted and when it seems there is nothing you can hold onto: But God. Remember who He is. Remember that He is El Roi, The God who Sees Me. Remember that He also grieves with us, and grieves even more deeply than we do, because His love for us and others goes deeper than we could comprehend. Remember He is our High Priest who understands our pain and intercedes for us. And if you have not yet, repent, turn to God that your sins may be wiped out (Acts 3:19). He stands ready to receive you (Revelation 3:20) if you will come. We all need reminders at times that there is so much more to life. That the simple things are why we can keep going. That death has been defeated, and for those of us who have received Christ, we already have the victory over all the evil that devastates our world. 

The Light That Overcomes the Darkness

    The ‘black cloud’, it is a title no medical personnel wants to carry or be associated with. In medicine it is reserved for the person who seems to have the worst cases, the most dramatic and crazy cases, or seems to have the most cases period. And then on the contrary few are labeled ‘white clouds’ meaning they typically get fewer cases or easier ones with less emergent procedures. And when a ‘white cloud’ and a ‘black cloud’ are on together every one wonders who will ‘win out.’ In the USA or Africa it is the same. Every team has a few physicians with each label and everyone else on the team silently or not so silently dread being on call with the ‘black clouds’ and breaths more easily when on call with a ‘white cloud’. Believe it or not there actually has been research done regarding this (PubMed "Black cloud" vs. "white cloud" physicians - Myth or reality in apheresis medicine?). Surprisingly (or not), there actually is no statistical correlation. So, why then in a scientific field that so heavily relies on ‘evidenced based medicine’ and statistically relevant data do we disregard the science and still have these superstitions? My personal belief is that we all need something or someone to blame. When the train wreck of a case comes in and you do everything right and everything just like you were taught, but the child still dies and you have to tell the family you tried but you were not successful. How do you deal with that internally? It is much easier to say, well it was because so and so was on and he is a black cloud. You can imagine it is not a great feeling to be labeled a ‘black cloud’ and can be quite discouraging. Is it because I’m cursed? It is because I’m not as good and so everyone dies when I’m on call? Is it because the Lord is preparing me for something worse later on? As you can see, Satan can use this little superstition to play many games with our heads. It is a constant battle in medicine whether we chose to notice it or not. 

To be clear, I am not endorsing this kind of labeling. I very much believe and am confident in a God who is 100% sovereign over every single detail in every single patient that comes in and who is there to provide care for them. But, the underlying stigma remains. In residency I was labeled a ‘grey cloud.’ Not clearly one or the other. I definitely had nights that made for crazy incredible stories. I had nights and days that made for heart wrenching stories. And I had plenty of and mostly days and nights without anything going awry. But isn’t it just like us to only remember the bad days and nights? It is so much easier to remember the bad stories that gripped our hearts and every single mistake we may or may not have made. But do we remember all the times that God provided and came through? The times He did heal and how out of our 40 patients all of them but the 3 are getting better and should go home. Or do we focus on the 3 who inevitably take 90% of our time even though nothing seems to work? Are we defined by the 3? Of course, we should always in everything we do strive to be and do our best. Our goal is always that 100% of our patients would get better and go home to their families healthy. 

But that is not up to us.

    And there’s the rub. No matter how you look at it, medicine tries to make everything about you; if you’re good enough or not, if you’re smart enough or not, how many patients you’ve lost or saved. As if any of this were up to us! We all need a daily, or even hourly reminder that NONE of this is about us! His ways are higher than our ways, and His thoughts are higher than our thoughts (Is 55:9). “God is in Heaven and does whatever He pleases” (Ps 115:3). He alone holds the keys to life and death (Revelation 1:18). “The Lord gives and the Lord takes away, blessed be the name of the Lord” (Job1:21). And maybe even more encouraging to a Christian physician (or any person really) fighting the lies of being a ‘black cloud’: “The people who lived in darkness have seen a great Light and for those living in the land of the shadow of death, a Light has dawned.” (Matthew 4:16); “That Light shines in the darkness, and yet the darkness did not overcome it” (John 1:5); “I have come as Light into the world, so that everyone who believes in me would not remain in darkness” (John 12:46); “For you were once darkness, but now you are Light in the Lord. Live as children of Light” (Ephesians 5:8); “God is Light, and in Him there is no darkness at all” (1 John 1:5). 

Praise the Lord! He is LIGHT! And darkness CANNOT overcome Him! Death is not the end, and it has been defeated. And for each of these precious children, made in His image, He has the ultimate victory even in their stories. For He made each of them, crafted them in their mother’s womb. And He has brought ultimate healing not only to their bodies, but for some even to their souls. He has truly overcome the darkness right before my eyes but I do not always see it. 

As you can imagine given this introduction, things have continued to be difficult here the past week. We did have a few calmer days, but each of my call days have come with very difficult cases. Last Monday early in the morning our child fighting Malaria passed away. Her case was hard for many reasons. She was the only girl in the family and her father and brothers wept over her. It also seems crazy to think that we are still losing children or anyone to Malaria in the 22nd century. But here we are. Overnight when I was on call we received a patient from another hospital who had sickle cell. She was in a sickle crisis and needed more respiratory support than this hospital could give. They intubated her and sent her to us. But when she arrived we were fighting a losing battle. We noticed that with every breath we gave her air was leaking into the skin and tissues around her neck, down into her arm, and even down around her heart (as seen on xray and CT). We had to give her breaths, but with each one the problem grew worse. Every breath literally saving her and killing her at the same time. Essentially we think that her trachea (air way) had been punctured when she was intubated making air leak into everything around it. We tried everything we could think of and brought in several other physicians to try to help figure out how to save her. But she passed away about 6 hours after arriving at Tenwek. 

    

    The next day we had a 10m old baby come in from another hospital also needing more respiratory support. The story was that 4 days prior she had fallen off the bed and when mom went to catch her a pot of beans that were cooking splashed in her face. But her entire face, ears, and part of her scalp were burnt pretty badly. But that didn’t account for the fact that she now needed to be intubated and had fluid collecting in her lungs. She was so sick when we received her that we could not get a single IV in her. We literally had someone trying to get a line in each of her 4 extremities while I bagged her. Peds surgery came and put in a central line and a chest tube and she seemed to stabilize for the time being. But something wasn’t right. Her facial burns were bad, but not enough to cause everything we were seeing. So, we checked her liver and kidney function and found out that she was already in fulminant liver and kidney failure. She was already getting acidotic. So my team went back to the family and asked more questions. And then we found out they had been treating her with ‘herbal’ medication for some time prior to her arrival. Herbal medication poisoning is way too prevalent here. Essentially the local medicine man gives the family a bag of leaves (who knows what they are) and they are told to grind them up and boil them in water and give them to the child. This is what lead to the demise of the first child who passed away after I arrived. The herbs lead to liver failure and then to Stevens Johnson Syndrome and he passed away after aspirating his food. In this patient it had not only injured her liver but also her kidneys at least. I still don’t know where the fluid in her lungs came from. Most of the day she stayed the same, but I had a horrible feeling about it. I was on call last night and went to see her before going to bed. We changed a few things that seemed to help, and we were treating her acidosis as aggressively as we could. For a minute I thought maybe she might turn the corner but she had not had any urine in almost 36 hours and her liver and kidney functions all kept worsening no matter what we did. This morning started with her heart slowly dropping but responding to CPR and 2 rounds of epinephrine. Her acidosis and kidney and liver functions continued to worsen despite all we did. So, this morning we had to tell the family that she most likely would not live through the day apart from a miracle from the Lord. We prayed with them, and they decided to make her DNR (Do Not Resuscitate). Then I was informed that I kiddo we admitted at sign out yesterday for a small oxygen requirement suddenly passed away on the floor overnight. He had CP and just had a little more work of breathing yesterday so the father brought him in. I looked over his chest xray with my medical officer and we noticed that his heart had been slowly enlarging over the past few months based on prior xrays. It was too late in the day to get an ECHO so we would have to wait until Monday. He was only requiring a small amount of oxygen and otherwise doing well, so we decided to treat him symptomatically until we could get more information on his heart. But overnight his father noticed that he no longer had a pulse. We are not sure when it happened or what happened. But CPR was done for a while with several doses of epinephrine but ultimately he passed away early this morning. 

    This morning as I was processing all that happened overnight I realized that I have only had 1-2 call shifts where all my patients lived through the night and into the morning. With the one last night there have been 7 children pass away since I arrived and one on the brink. But the Lord has been gently reminding me this morning of all the ways He has provided and brought healing during my time here. My initial baby with pneumonia now 11 weeks old, will hopefully be extubated in a few days. For about a week and a half after he arrived I thought he was going to die on me almost every single day. But at one point he was so close to death our team just stopped everything we were doing and prayed over him. We prayed for God to intervene and work a miracle. And God did. He ‘suddenly’ stabilized and has been improving since. Multiple kiddos with TB, or HIV, or bad meningitis or even fungal infections in the brain, kids with nephrotic syndrome (kidney disease) have all improved. Tiny little premature babies are thriving and growing and feeding well. And even several others that have had poisoning of various types, some herbal medicines and some accidental, have improved and gone home healthy. 

    So, despite the temptation to make it a numbers game and calculate the mortality rate of my patients while I have been here, I’m choosing to praise the Lord for the ways He has brought healing. Healing on earth and ultimate healing in eternity. And praising Him because in Him I cannot be a ‘black cloud.’ No, I am His child, and therefore the Light is in me. And the Light that overcomes darkness. I will give my best, and continue to pray that the Lord makes me a better physician every day. But I am continuing to learn to surrender to how He chooses to bring healing and Light to these families and patients. 

Uphill Run

You know that feeling when you’re running up a really big hill? You put your head down, focus on your breathing and increase the power in each stride. Four steps as you breathe in and four steps as you breathe out (at least for these short legs). Watch that log, and that rock, just keep going, don’t slip. In and out, you’re almost there. Muscles are burning, lungs start burning, but you’re so close. Once you reach the top you gasp for air and you may even pause as your lungs and muscles scream, but you have to keep going. At least now you can raise your head. The run for the moment is not as strenuous, and maybe even enjoyable. Now your head is high and your focus is the incredible scenery around you and not how hard it is to take each step. As you allow your thoughts to consider the beauty of the stream that runs beside the trail it almost feels like your feet are gliding across the path. The intensity of the run has changed but what really changed is where you kept your focus. 

            Since last Monday things continued to be just as busy and adrenaline producing as the first few days. Thankfully however, I was not on call nearly as much. One of my pneumonia kiddos passed away shortly after I last wrote. Her heart just gave out. We had a new child come in with blood pressures that were super high, and I had a good time teaching the students and interns how to think through the differential. On Wednesday we almost lost a teenager to severe malaria as her blood level dropped severely low and her body was both clotting and bleeding at the same time. A condition called DIC. We were able to effectively treat the malaria, but the damage that had been done was incredible. Her lungs filled with fluid, her liver and kidneys shut down and she was bleeding like crazy. Then her temperature spiked so we filled gloves with cold water to place on her body. However after the first few gloves, the water turned warm and wasn’t helpful. We had students running to other sinks in the hospital for cold water. On top of this, in Kenya the options for treating her kind of bleeding are few and not ideal. We needed fresh whole blood and at the time did not have any. So, I walked down to the blood bank and started filling out paperwork to give her my own blood. But just before I gave we found some fresh blood for her. I was relieved when I came in the next morning and she was still alive and even a little better. 

We almost finished rounds that morning without a crisis. . . almost. I was waiting for my intern to come to the NICU to finish rounds but we finally had to page him because it was taking him way too long. And of course he was at the bedside of my original pneumonia infant who was awake again and dropping his oxygen saturations. The one IV line we had stopped working, and so he was no longer getting any of his sedation. This time it wasn’t as easy as before. We worked for a good 3 hours total. We were unable to get an xray because we couldn’t get the portable xray down to where he was and we were also unable to move him to xray because he was too unstable. We got an ECHO bedside and it showed that the pressure in his lungs had significantly increased since his first ECHO. My heart sank, because I knew this meant he has a very small chance of recovering from this. While this was going on we were trying desperately to get another line in him. But no one could get one. We called anesthesia who came with an ultrasound and finally got one line, but couldn’t get another. We got a few medicines in him but still he was not settling. His heart rate was dropping and we had to give multiple medications to keep it up. Then that line failed. I really thought that was it for him. Finally one of the surgeons came and put in a central line for us. Once this happened and we could actually get medicines in him he finally settled down and his oxygen level and heart rate stabilized. But now it was taking multiple medications to sedate him and multiple medicines to help his lungs and his heart rate. We all knew that his prognosis was very poor. That was a very hard conversation with his mother. That night on call he did okay though his heart rate still dropped a few times requiring extra medicine. I slept some but woke up every hour or so out of anxiety more than anything. Friday morning just as I was getting out of bed for the day I got a call that another of our kiddos was having trouble. So without brushing my teeth, or changing out of my scrubs from the day before I ran back up to the hospital. One of our kids came to us a week ago from another hospital with multiple abdominal abscesses and a horrible pneumonia. He was, until that morning, the most stable of our critical patients. We rushed him to xray and found out that essentially only one of his lungs is working currently. 

            I left after ICU rounds to get about 30 minutes of sleep, get ready and then left with the physio department to deliver a wheelchair to a child with Cerebral Palsy out in the village. We were able to custom fit the wheelchair for him. Watching him smile was incredible. Due to his condition he cannot sit on his own and spent most of his life lying in bed. I watched him grin as his eyes looked all around. His entire family and many members of the community came out to welcome us. We were able to share that this chair was a gift and that God loved this child as He does all people. We shared that Jesus died for each of them and prayed over them all. And then of course in normal African fashion we had chia before heading back to Tenwek. It was a nice end to a very busy week.

            Yesterday I had my first day off since arriving at Tenwek last week and it felt very similar to the description of running up a hill as described above. To be honest, I don’t mind working a lot. And I even considered going to the hospital yesterday just to help. But I knew that since arrival I had not really had time to sit before the Lord and just be still. I could feel it in my soul. I had been living in survival mode just trying to keep up with the medicine. My worst fear coming here is that I would make things worse by my incompetence. And several times in the past 10 days Satan has played on those fears making my pride roar loudly. But I knew God wanted me here. What I’m realizing however is that He wanted me here so He can work on me, not because I am needed. He will accomplish His work in the lives of these children with whomever is available to serve. But He invited me here to refine me. Most times when I serve overseas it seems so much easier to hear God and I ‘feel’ closer to Him. Typically there are less distractions and more time to be still. I guess I just assumed that would happen again as effortlessly as before. But all last week as I would pray He felt distant and my time with the Lord was always rushed (typically because most mornings I had at least one critical patient trying to code on me). But yesterday morning I could just be still. I woke up that morning on edge with every little thing making me way too anxious. I knew I needed the Lord to intervene, and He did. 

            It is always amazing to me how much peace and joy come when you simply shift your focus. I remember when I started medical school my prayer was that no matter how intense and overwhelming medicine became that it would not cause me to lose sight of the God who called me there. For those of you in medicine you know that it can easily become all consuming. But there is only One who is an All-consuming Fire. Just like Peter in the midst of the storm as he walked on the water. The circumstances and situations around us may require attention and may  be drastic (code after code after code and all the alarms). But the focus, and the center of our universe should never shift from Christ. The Lord knows these circumstances and situation better than we ever could. He knows the exact pathophysiology of each patient I encounter and how it has been corrupted by disease (ultimately sin). He knows exactly what each patient needs and exactly what I need. And He has promised to supply all of those needs for His children, whether here on Earth or ultimately in Heaven. And it is a supply that never runs out (something I have learned to not take for granted because that happens often here). No, His supply is according to the riches of His mercy. Riches that we could never comprehend. In fact He says to seek Him first and then all these other things will be added. So this weekend with the rest and downtime the Lord has given me, He is using it to redirect my focus and refine me. He has pointed out idols that I have allowed to creep back into my life and areas where I have lost my footing. He is humbling me, and I am so thankful. For those whom the Lord loves He chastens. I know He has work for me to do here that is not medical. Work on myself and maybe some encouragement for others. As I have been praying through things it seems I am to pour into our pediatric team: make disciples who then make disciples. And of course always be ready to give a reason for the hope that is in you no matter what situation or circumstance. I have been brushing up on the Gospel and rememorizing many of the verses and it has been water for my soul. I pray the Lord brings you to such a place no matter what circumstances you find yourself in. 

Deep Breath

Deep breath. 

 

I arrived at Tenwek hospital last Wednesday. It was nice coming back to a familiar place though many of the people I have worked with in the past are currently not here. I knew it would take me a while to readjust to hospital medicine and the best way to acclimated fastest is to jump in head first, right? My first day on service I was on call that night. It felt like it took forever to get those wheels turning in my brain on rounds that morning. Our peds team consists of myself, a family medicine physician, 2 medical officers who are very well trained, and several residents and students. For my first few days there was also another pediatrician from the states helping with the service and I was so thankful to overlap with her some. The service overall seems busier and has more critical patients than I remember having last time. With each day of rounding I settled into things a little more. 

 

We have already had a significant amount of pathology. In medicine that can be fun and interesting to see strange and varying diseases but at the same time it is usually not good for the patients. In my first 4 days of work I have seen HIV, TB, Cryptococcal meningitis, Pneumocystis jiroveci pneumonia, cerebral malaria, filariasis, toxic epidermal necrolysis that progressed to Steven Jonson’s Syndrome, a ventriculoperitoneal shunt infected with Giardia, multiple abdominal abscess that seeded a pneumonia in a kid after surgery (from an outside hospital), rheumatic heart disease and heart failure, nephrotic syndrome, little babies with multiple congenital anomalies or intraventricular hemorrhages, multiple pneumonia cases, and liver failure from herbal meds. Right before I came, the team did an exchange transfuse for a baby with a bilirubin level that skyrocketed. Thankfully I got to discharge that kid home recently. Praise the Lord!

 

This weekend I was on call and the patients kept us on our toes! On Saturday I ran my first pediatric code since residency and by the grace of God it was successful. An infant pulled out his breathing tube and his heart rate dropped because he couldn’t breathe. We had another baby admitted that evening for pneumonia that initially did well on oxygen but worsened throughout the day. That night we decided to intubated after trying CPAP. It took us a good 1.5 hours to get her to stabilize and I was very concerned that we would lose her right there. We battled and fought for these two infants most of the weekend. Multiple times I thought one would not make it. And of course they both decompensated around 1am last night. I spent about 4 hours at the hospital trying to stabilize them both. I was so thankful for the 7 hour time difference between here and the US. It allowed me to ‘phone a friend’ who walked me through how to stabilize these very sick lungs. A few of our other really sick kiddos seemed to be improving yesterday and I was very thankful the Lord had sustained us through the weekend despite how critical so many of our patients were. I felt like if I could get them to Monday with the whole team then just maybe they would make it. However, as I was getting ready for rounds this morning I was paged to the bed of our infant with TEN/SJS. He looked so much better yesterday that we started feeding him because we knew he had to have the nutrition in order to recover. But, this morning he aspirated on his food. When I arrived, the surgical team was intubating him. For 3 hours we worked trying to get oxygen to his lungs. The problem was that his disease was also inside his throat and esophagus and he started bleeding internally with all our efforts. He passed away at 10:30 this morning. At the same time one of my pneumonia kids starting fighting the ventilator and decompensating. I was literally running between both beds for over an hour. At one point we all stopped and I just laid my hands on one baby and prayed that the Lord would intervene. We tried everything we could think for them both. Then suddenly, the oxygen level in my baby with pneumonia picked up. I don’t actually think we did anything. But I know God answered our prayers. As of right now he is still okay but still so sick. And then just like that, after 3 hours of running around and one baby dying, we had to pick back up and go see all of our other patients. My morning ended with a hard conversation with a mother who’s baby is terminally ill. I had to explain that her baby will most likely die in the next few days and there is nothing we can do. I sat with her for a while as she wept and we prayed together. 

 

I have definitely had moments the past few days where I had to stop and take a deep breath remembering where my strength comes from. Much of this can be overwhelming and it is easy to throw your hands up because it is so obvious that you’re not enough. I had a moment one night as I was staring at a ventilator wracking my brain for what to do (that has been happening too much recently) where I started question why in the world I came or ever thought that I could be useful here. It is too easy for the enemy to get a foothold. I stayed up that night refreshing myself on details of ventilator management. It got me thinking on the delicate balance of striving hard to do our best but then leaving the outcome to the Lord. Yes, I want to be a better physician for these kids and their families; not only to better serve them, but also because I represent Almighty God. And yet, I have to be able to lay it all on the alter for God to do what He wishes with my sacrifice. Yet, this is not a new thing that God requires. Did He not require the very best of Cain and Able on the alter? And so, I’m learning to always strive to be better; not for my glory, or even better patient outcomes, but simply that I may be able to lay my best on His alter. It is a hard lesson. 

 

The baby that is currently giving us the most problems is an 8 week old baby I admitted a few days ago from an another hospital with severe pneumonia. They had him on some antibiotics for a few weeks without improvement and he then started dropping his oxygen levels. The medical officer on with me that night is very good and so when she called I knew something was up. He had to be intubated because he couldn’t keep his oxygen level up otherwise. But he is a very strong baby and was fighting us like crazy. We were breathing for him but he resisted every breath so that the oxygen was not getting to him. If only he would give it up he would be able to breathe. We had to sedate him heavily to get him to calm down enough for him to stabilized. His body needs to fight this infection, but then stop fighting us when we are helping. 

 

But am I not in a similar situation with God right now. I need to fight to learn and strive to better understand disease and pathology in order to better help my patients. But I also need to surrender those same patients to the Lord. How many times do we have destructive behaviors and fight God with all we have because we don’t like what He is doing. We know He only does good things. He is a good father and knows how to give good gifts (Matt 7:11). But just like this infant sometimes when He is refining us (maybe disciplining us, maybe not), we resist that unpleasant sensation/situation and fight with all we have. But are we not really just making everything worse? We know from Scripture that He calls us to surrender, and when we do He has His way in us which is for our good and His glory. Are we going to surrender on our own? Or will He have to force us? Thankfully, in the end God will have His way in us. We have the hope that He will finish what He starts in us. Unlike this infant, we can trust that no matter how we mess things up, God is powerful enough to still have His way. But we can definitely make it harder on ourselves. Obviously, we can and should still have emotions during these times. And expressing those is healthy and part of how God made us. But maybe we don’t have to resist Him. Lord, I don’t like what you’re doing and I’m hurt/angry/sad/etc but I know you are God and you are good. So, I surrender to whatever it is you are doing and trust it is for my good and your glory. 

 

If only my little 8 week old could learn that same lesson . . . 

 

Thank you all for your prayers. They are felt and very needed. Please continues to pray for these very sick children, for their parents and families during these hard times, and for the team, that the Lord would continue to sustain us. Please also pray that in the midst of the crazy and business of the medicine that the Lord would give me more opportunities to pray and talk with patient’s and families of His goodness and love. 

On To Another Adventure

Ten years ago this fall I walked into my parents house after weeks of fasting and praying over the direction of my life. I had gone to college to do what was fun and comfortable and made sense but then someone called me out and asked me to pray about what God wanted for my life. At the time, she was suggesting medical school and that seemed like an impossible task. Nevertheless I prayed and fasted more so out of obedience. But my heart wasn’t in it. Until that night. I remember it clear as day. My father met me at the front door with his book in hand. Someone had given him a book with facts about all of the countries in the world and their people groups etc. He told me about the infant mortality rate in the country he was reading about. It was so high because there were no women physicians to care for the women there. And as if time stood still in that moment I knew God had called me, as a women, to be a physician in order to reach the underserved. It’s been a long hard journey, but now 10 years later I’m on my way to Kenya to serve as a physician. I have visited Tenwek before but as a resident with close oversight. In the coming 4 weeks I will fill in for the long term pediatricians as an attending. So many emotions as I sit on the plane. The past few days have been a little stressful getting everything ready. The anticipation just adds to the stress. But now finally I can sit and focus. Focus on the One who called me 10 years ago and the One who is calling me now.  

This past week I was on vacation with my family in a Gatlinburg. We typically get a cabin just by Little Pigeon River at a little swimming hole with a big rock perfect for jumping off into the water. As an added benefit my grandfather was able to come join us for a day and swim in the river with us. He is a great reminder to me of the grace and goodness of the Lord. He grew up in that area when his family worked as tenant farmers in what is now the great smokey mountains national park. As a kid he would walk down to that very rock and jump off it to swim in that river. This vacation he told us how they ended up moving to Knoxville when he was around age 9-10. During the Great Depression the farmer his family worked for did not have money to pay them. They skimped by as the Lord provided. But then the national park came in and essentially said they all had to leave. My great grandfather had no choice since he didn’t own any land. The farmer decided to move his farm to Knoxville and asked my grandfather’s family to come along but my great grandfather was not convinced.  What ultimately changed his mind was a visit he took to Knoxville to check out the local church. Essentially the Lord lead him right to the doorstep of a deacon of the local church and after discussing the church my great grandfather decided it was okay to move to Knoxville.  I never knew him, but it sounds like he had his priorities right. My grandfather got his degree in Knoxville after serving in the navy. He worked his way up to being CEO of the same company he started working for out of college. But then retired early to go serve in Rwanda. He and my grand mother were there when the genocide occurred and had to be evacuated. They then helped in refugee camps. To this day he says those were some of his best memories during his years in Africa. This is a short glimpse Into my heritage and the family the Lord gave me. Psalms 103:17 (CSB) “But from eternity to eternity the LORD’s faithful love is toward those who fear him, and his righteousness toward the grandchildren.” What an incredible blessing to be one of those grandchildren! 

You see my life and any ‘good’ thing that comes from it is all a result of immense grace. I did nothing to deserve to be born in a Christian home where I was taught about the One True God. I did nothing to deserve to be brought up in a country where I have opportunities galore. Yes, I have worked hard the past 10 years to be a physician and be able to help people. But what I deserve . . . I deserve death and an eternity in hell separated from the only Being who can satisfy me and make me whole. BUT GOD, who is overflowing with mercy and grace called me out of death and gave me life. He gave me this family and heritage and these opportunities. Who am I to waste them? So, I lay myself, the gifts, talents and material wealth He has given me all on the alter. I have been the recipient of grace that is beyond measure and now I get the opportunity to be poured out as His hands and feet to the sick and hurting, those close to physical and spiritual death. And while the last 10 years have given me a few tools to help their physical bodies, the true gift and best thing I can give them is the very Gospel that saved me. That Christ came to Earth and paid the penalty for our sin and we can have forgiveness and righteousness and a relationship with Almighty God! That void that we all feel that we always try to dull and nothing works: I have the answer, and He is more beautiful than you could ever know! 

What is even more glorious is that we can all bring this amazing news to anyone at any time. I don’t have to be at a hospital in Africa to be His hands and feet. You and I can do this everyday with anyone the Lord brings to us. May He awaken us to the greatness of who His is and His Gospel! May it permeate us and overflow from our souls onto everyone around us! May we not be able to keep it in our bones! I’m on my way to fulfill something the Lord called me to long ago. But we can all fulfill the purpose He has called us to each and everyday. 

1 Corinthians 15:55-58 (CSB) 55 “Where, death, is your victory? Where, death, is your sting? 56 The sting of death is sin, and the power of sin is the law. 57 But thanks be to God, who gives us the victory through our Lord Jesus Christ! 58 Therefore, my dear brothers and sisters, be steadfast, immovable, always excelling in the Lord’s work, because you know that your labor in the Lord is not in vain.”

I don’t know your story or where you have come from. But my life is evidence that God makes beauty from ashes and brings the dead to life. If He can do this is me, I have every confidence He can do so in you also. The question is, will you surrender

All We Need and All We Want

This month I started a new season of my career. As a fresh green attending out of fellowship less than 6 months I had my first medical student. It has been a little difficult remembering what these 3rd year medical students know and aiming to teach and point out things that are useful. I think at times I get over zealous in teaching and go too far. So, recently I went back to read my prior blogs around the time when I was about to start my clinicals. Man, did the Lord teach me even just reading what I wrote 6 years ago. At the time of the blog I just read (June 29th 2014), I had just finished board exam #2 of 6 and sat by the ocean contemplating what kind of clinician I would be when faced with the suffering of my patients. Even then I was praying that the Lord would use me to bring hope, love and comfort in the darkest nights. My eyes were set on the only Hope Himself. As I read through this I thought of the faces behind the hardest cases, the lives touched by suffering I could never have imagined. I had no idea at the time what the Lord was asking me to walk in to. Yes, He has been faithful. So many times during medical school the cry of my heart was “God, I need you!” I would surrender it all to Him confessing that if He did not come through I was done. I would cry out as Moses did in Exodus 33, Lord if you do not go with me, do not send me! The common thread throughout my medical school and residency career was my utter dependance on God. 

Yes, residency was hard. The hours, the lack of sleep, the amount of information and knowledge, the hard cases, and the sheer number of cases it all stretched you to the brink. Yet, in my last year as the Lord allowed me to grow as a physician I grew comfortable and began having some pride in my work. And as soon as I hit a good stride it was over. Fellowship was a good year, but again as soon as I seemed to get settled the Lord moved me again. 

So, now I find myself finally done with school after 25 years. My first “real” job but it looks nothing like I ever imagined. I’m living in a state I have no ties to nor had any desire to ever live in. I’m in the US and not overseas, I don’t’ have either of my long time companions through school. I’m still single.  I’m finally through the end of the tunnel (and what a long tunnel it was) and I find myself still discontent. How is it that when I started this journey God was enough, but now that it is over my heart is no longer there? For the first time in 8 years I have the free time of a college student but I have no studying that must be done. For years when people asked what I liked to do for fun my answer was sleep. But now I actually get to sleep like normal people and I have found myself struggling with a “normal” life. What do I like to do? What would make me happy? Who am I? It seems a little dramatic, but these are for real the questions that have been circling in my head the past few months. For course, COVID makes things worse and harder to get to know other people in the area or get out and find fun things to do. But should that even matter? As a young attending I would also find myself second guessing my every decision at work because now there is no one looking over my shoulder to catch my mistakes. Almost daily again I am back to that long time prayer, “God I need you” again if He doesn’t come through then I have nothing to give. But I’m tired of this endless cycle of survival mode and changing and taking 3 steps forward and 5 steps back. Add in the pressure of the state of our earthy country and it is too easy to be discouraged. 

Yet, the Lord did not give us a spirit of fear, and over and over we are told that Christ is enough (2 Peter 1:3). I’m tired of not being all that God has called me to be. There obviously has to be more. So, as our church started a series on Ecclesiastes I felt as though it couldn’t be more relevant. Solomon, king of Israel, wisest man to ever live, and wealthiest man to ever live. In all his wisdom and all is wealth what he writes to us is that it is all vanity. And can we not see it in our everyday lives today? COVID hit, and so many people are waiting on human wisdom to come up with a solution, a vaccine so we can get ‘back to normal.’ Yet, as a vaccine is rolling out (which really has been an amazing scientific feat) new variants of the virus form reminding us that we really are no match for what is going on. And, really do I even need an example of how material wealth doesn’t provide happiest but rather actually causes quite the opposite? Time and time again we hear of people who thought money was the answer only to find they were more empty inside. But the one that got me and has helped me take a step closer to being who God is calling me to be, is that even our work is all vanity. 

Y’all, I just spent 8 years of my life, AFTER college to become a pediatric sports medicine physician. I have sacrificed time, and sleep, and food, and money, and brain power, and sweat and tears for this. And yet I have felt the weight of the emptiness as I face a family looking to me for answers when I have none to give. I have worked and worked and worked to save a life when it seems to slip away despite all the toil. And, to be honest, 10 out of 10 people die. So what am I doing anyway? Only prolonging the inevitable? Why did God put me through all of that? Why is it that I can make correct decisions all day long but if I miss one single detail I feel as though I failed and the day is wasted? This is the reality when we face medicine, or anything really without the foundation of Christ. I didn’t go into medicine for what it brings me, or the joy I get from being a great doctor. I didn’t go into medicine to become wise or wealthy. I didn’t go into medicine to save the world. I went because I was called. I went in obedience and for the glory of God. And as Solomon reveals in his book, this is the ONLY thing that gives life meaning. 

The past few weeks I have been praying for the Lord to change my heart. As I don’t really remember all the hobbies and ‘things’ that used to bring me happiness, I am faced with an opportunity to fill my free time with something that truly matters. I can see Him starting to do this at work. Each day I have to surrender to Him every patient, family member, and colleague that I will encounter that day I can feel His Spirit giving me peace, joy and wisdom as I work. I can truly say I enjoy my job, and not because of all the earthly benefits. I really think that even if all my loans were paid off, my retirement set and I had enough money to live on, I think I would still be a pediatrician for free. I enjoying being the hands and feet of God. But, when it comes to life outside of work I have struggled finding my footing. I really don’t know what I want. And so I feel myself drifting. With no studying to do it’s too easy to waste time watching TV or anything to turn your mind off. Not that these are bad things in and of themselves. But as this happens I feel myself having a harder time hearing God speak and the lies that Satan throws at me seems to make sense and are even louder.

For the past few days my mind has wanted to drift into made up worlds of “what if.” Why is it that it’s so much easier to live in unreality. Are we, am I, running from something? Or am I just so lazy that when I’m not forced to be present I prefer to be in a world of my own making instead of facing the daily grind with all that it brings? Last night as I just let my mind drift I realized for the first time in a long time that it did not bring the peace or escape from reality I was hoping. See the past few weeks the Lord has been refining me in such a way that even I can see His face more clearly. This past year brought so much heart ache and a deeper pain than I have ever felt. But, I think the Lord is finally showing me the fruit of that season as I continue to move forward towards Him. And so last night as I tried to just let my mind go watching television or day dreaming or even just sleeping it occurred to me that these things really do not fulfill me, they are all in fact vanity. They dull my mind to what the Lord is teaching me and make it harder to see Him and be changed by Him. So, I decided to read something productive last night instead. As I opened “Emotionally Healthy Spirituality” by Peter Scazzero the very first line of the chapter I was on read, “There is no greater disaster in the spiritual life than to be immersed in unreality.” Yeah, no joke. I paused. Wow Lord, I think you are trying to tell me something. You see, what the Lord is making more and more clear to me is that what I want is joy, and peace, and rest. And while it seems like I can get some of those things watching Netflix all day long or daydreaming of a better day really I can only find those things in Him. Just like Solomon said thousands of years ago. So, this morning as I began my prayers before diving in the Word I started with my common cry, “God, I need you” and yet for the first time I can remember, as if from an overflow of my soul I cried, “I want YOU. And only you.” 

What an amazing wonderful grace that the Lord would sanctify me in such a way as to show me that no other things in the life are worthy of my “want” but Him. That truly nothing else satisfies and nothing else can be used in its proper form until we are right with God Himself. Because when He satisfies us, everything else is in its proper place. I can enjoy friendships, and singleness, and my job, and my free time because I am already satisfied in Christ and they are all icing on the cake. And then when one or more of them are taken away, my foundation is secure and my Hope remains. Sanctification is a beautiful thing. And what makes it even sweeter is that apart from any of my own doing, God Himself chose to draw me closer and make me more like Himself. Grace, amazing grace! My prayer for you is that you too would want Him above all else. And that you would the find complete satisfaction in the only One who gives purpose and meaning to life. 

Wake Up Church!

I came across a section in the Bible study I have been reading lately (“Behold Your God: Rethinking God Biblically” by John Snyder) that stopped me in my tracks. As I was casually reading through paragraphs to finish before I needed to leave for work, I came across a section that made me stop and think. And it has continued to turn in my mind since. God has called us as His church to be holy, as He is holy (Leviticus 20:7-8). This is something I have known and read may times. Yet, practically what that does mean in my life and am I living that way? For real. This study goes on to state that Jesus is the bases of our holiness (yes okay). We have to keep our eyes on Him to keep moving forward, (yep got that). But, to look to Jesus and keep our eyes on Him we have to turn our eyes away from other things. (Ok, yes that makes sense). But we don’t just look to Jesus we have to have a determined focus on Him (yeah that seems more like real life). And we look away from sinful things (duh) but also distractions (oh).  

 

Here’s the thing, we as Christian say we believe the Bible. It tells us that this Christian life is not a cake walk. Rather it is described as taking up our cross daily. The true Christian life is hard. We are told it is a sacrificial life that requires that we turn away from things that do not satisfy and turn to the only One who can satisfy us. I have found that I have gotten comfortable as a Christian in America. Especially these last 4 years where the new threats to my beliefs and my faith have been minimal. Now that I am no longer in residency and fellowship and I have all this “free” time the temptation to spend it watching TV, Netflix, etc is strong. For the past few months I have been trying to “figure out” what to do with all this time to not waste it, yet I still come home and turn on the TV because it’s so much easier. But here’s what I read this week from John Snyder’s study regarding dealing with distractions in our life. When John Wesley was at Oxford he too found himself with extra “Free time” and at first was spending it playing cards and going to the theater with friends. Yet, he struggled with the idea that using his time this way was not pleasing to God. Here is what his mother wrote to him after he told her of this struggle, “Whatever weakens your reason, impairs the tenderness of your conscience, obscures your sense of God, or takes off the (desire for) spiritual things . . . that thing is sin to you, however innocent it may seem.” 

 

Don’t get me wrong here, I am not trying to be legalistic. We are commanded to not judge others or let other judge us based on food, drink, festival or sabbath (Colossians 2:16). But the point is that yes in Christ you are free to do _______, yet if it causes you to be distracted from Christ, causes you to not desire Him as much or makes you less like Him then it IS sin for you. Someone else may be able to watch Netflix all day and it not hinder their love and desire for Christ, but I find that when I watch too much TV, I become lazy and I do not pursue Him as I should. What stopped me in my tracks this week was the still small voice that asked me this question, “Am I worth it to you? Are you willing to get rid of all these distractions to know Me deeper?”

 

I wish I could tell you that I immediately gave a wholehearted “yes!” But that was not the case. You see I knew that my heart was not there, not yet. Yes, I want to be there, but I need to count the cost. Jesus teaches us to do this in Luke 14:25-35. And so, the past few days I have had quite the internal struggle. What it comes down to is this. We all have a void in our lives made for God alone. We can try to fill that void with TV, friends, a spouse, children, alcohol, drugs, sex, whatever. But that only intensifies the need for something greater because those things can NEVER replace the One made to fill you. What I see happening in America and in the church in America is this very thing. We have become comfortable and are trying to fill ourselves up with things other than Christ. As John Snyder puts in in his Bible study, “We drink down sin as if it were water. It goes down easy. We are often unaware that we are sinning.” And when you think about it, he is so right. How often do we as Christians think that we are still living ‘holy” lives when we waste hours a day on social media, playing video games, or binge-watching Netflix? Satan doesn’t have to get us to blatantly sin, he distracts us with all the things around us and then creates such pride in us that we think we are “ok.” Don’t be fooled! Wake up Christian and look at yourself. Do you truly hunger for the Living God more than you do entertainment or pleasure? 

 

Listen to this warning from James. “What is the source of quarrels and conflicts among you? Is not the source your pleasures that wage war in your members? [4:1] . . . You adulteresses, do you not know that friendship with the world is hostility toward God? Therefore, whoever wishes to be a friend of the world makes himself an enemy of God. [4:4] . . .But He gives a greater grace. Therefore [it] says, "GOD IS OPPOSED TO THE PROUD, BUT GIVES GRACE TO THE HUMBLE." [4:6]

Submit therefore to God. Resist the devil and he will flee from you. [4:7] Draw near to God and He will draw near to you. Cleanse your hands, you sinners; and purify your hearts, you double-minded. [4:8 ] Be miserable and mourn and weep; let your laughter be turned into mourning and your joy to gloom. [4:9] Humble yourselves in the presence of the Lord, and He will exalt you. [4:10]” (emphasis added)

 

This is what I have been honestly asking myself this week. Am I willing to go deeper, to make practical steps to get rid of the distractions that make me think this world brings me pleasure instead of the God who made me for Himself? 

 

(long dramatic pause . . . because this takes some honest thought) 

 

Ok, so let’s say that we are willing to let go of all that distracts us, repent, mourn, and pursue Christ. How do we do that? Jesus warns us in Matthew 12:43-45 that if all we do is get rid of a temptation or sin and do not fill that void with Christ then the temptation returns with a vengeance. And so, as we turn from these things we must be determined to fill our minds and lives with Christ. “But we all, with unveiled face, beholding as in a mirror the glory of the Lord, are being transformed into the same image from glory to glory, just as from the Lord, the Spirit.” [2Co 3:18] John Berridge wrote about it like this, “The mind assimilates itself to what it thinks much upon; grows more worldly by thinking on worldly things, and more spiritual by thinking on spiritual things. The spiritual mind grows much by prayer, and meditation on God, his love, and his word; upon Christ, his grace, and free and full salvation; upon the Holy Spirit and his sweet and powerful influence; the need of humiliation, watchfulness, and self-examination perpetually.” 

 

What am I filling my mind and time with? What image am I being made into? Here’s the thing, I believe in perseverance of the saints (topic for another day). Meaning that I fully believe that once God opens your eyes to His Gospel and you repent, believe and submit to Christ as Lord of your life that you are His for all of eternity and NOTHING can separate you from Him. So, if I am already His and my actions do not change that, why does it matter if I am living a so-so American ‘Christian’ life or if I give up all these things to run wholeheartedly after Christ? “So then, because you are lukewarm, and neither cold nor hot, I will vomit you out of my mouth” Revelation 3:16. The Lord does not call us to a comfortable life, but to a life lived on the road to Cavalry. The “American Church” has been lukewarm for way to long and we see the effects of it now. 

 

Church wake up! We have enjoyed religious freedom and become too comfortable. But persecution is coming. The events of this year remind us that the Lord will not strive with us forever (Ps 103:9) as He did not strive with the Israelites forever. The Lord is about to sift us like wheat. With the election of the most pro-choice president and vice-president in our nation’s history my job is about to get much much more difficult. There is already a motion to make physicians honor the wishes of children to undergo sex-changes regardless of their parent’s wishes down to age 8! The day is coming when Christian physicians will be fired for refusing to perform an abortion, refusing to be part of physician-assisted suicide, or refusing to allow an 8-year-old to undergo a sex-change. Are we going to stand for what the Word of the Lord says in the days to come, or are we going to be lulled to sleep by the distractions of our world today? 

 

I can tell you that I cannot do this alone. I am not strong enough to resist all these temptations and distractions. That is why we have to draw near to God and ask for His grace and mercy. But we also need to keep each other accountable. Ecclesiastes 4:9-12 reminds us that with each other and Christ we are a cord that is not easily broken. Who is willing to go deeper with me?

 

When the Lord sifts the wheat from the tares, where will you be? Where will I be? It may seem like this is a big jump from the beginning of this post, but I don’t think so. These are serious times, and I think the Lord is asking us as His church to wake up. “Submit therefore to God. Resist the devil and he will flee from you. Draw near to God and He will draw near to you. Cleanse your hands, you sinners; and purify your hearts, you double-minded. Be miserable and mourn and weep; let your laughter be turned into mourning and your joy to gloom.  Humble yourselves in the presence of the Lord, and He will exalt you. [James 4:7-10]”