Category: Reflections on Life, Being Human, and Medicine

Reflections on a variety of topics. My hope is to stir your thinking and perhaps even give you things to talk about in regards to what it means to be human, about life in general, and often times on the practice of medicine.

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Being human Reflections on Life, Being Human, and Medicine Reflections on the Christian Life

Intolerance, The Church Lady, and a True Definition of Tolerance

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The image is a common one. It is funny to laugh at the “church lady” on Saturday Night Live. “Well, isn’t that special!”  “How convenient!” 

It is much less funny to see it in reality. The image is of a “religious” person who is self-righteous, judgmental and condemning of everyone around them. It may look funny as a caricature, but the reality is disturbing and shameful. It also reflects the unfortunate reality that there is some truth that made this character popular. But the image is also a “straw man” argument that is used by many to deny the reality of thousands of true, caring, and sincere Christian believers.

I think the opposite is actually true.  I think my Christian faith makes tolerance much easier for me than it may be for others.

Many will think that is paradoxical. Please bear with me while I explain.

I do not expect everyone to agree with me. I do not expect everyone to make the same life choices that I do. In fact, I have gotten quite used to it. I am not surprised when others think or choose to live differently than me.

Just as importantly, I hope and truly want everyone to let me believe, think and live as my conscience dictates. It would be a deep crime against me if you were to insist on forcing me to only adopt your thinking. We all know the fights that have ensued through the centuries of mankind when one side or the other has tried to do this. And it never really works. You don’t change how people think by forcing them to think your way.

We are always going to think differently from others. The only answer that humans have worked out that seems to work is to allow freedom of thought and conscience. I expect you to give it to me. It is only reasonable that I should expect myself to give it to you.

This is of course with the caveat as long as we are not causing harm to others. There is a component of societal norms and laws that we know we have to have in place. And sometimes debate is necessary to figure out where those lines fall. It is not surprising that there will need to be some work and struggle to figure out those limits within a pluralistic society. It is of course not a perfect world. It seems the best answer we have come up with is to debate and then legislate the boundaries. Beyond that then we have decided to embrace liberty and freedom for individual thought and behavior.

And so, it is easier for me to be tolerant than people might think. I do not expect everyone to think like me. They often do not.  I do not expect everyone to live like me. They often do not.

I find then that with patients it is far easier to not be surprised. Patients might make all sorts of lifestyle choices. I hesitate to mention them here because this blog posting is not about debating whether certain specific choices are right or wrong. That is not the point. The point is about my ability to treat everyone with appropriate care and respect even if their personal choices disagree with my own.

This does not mean that I must agree with their choices. That is where many people get confused. There is a big difference between tolerance and agreement. We talk about living in a pluralistic society. This means that our society is based on letting us live peacefully side by side even though we may disagree on certain things. I do not have to agree with your thinking or your lifestyle. But I must respect your rights to have your thoughts and to live your lifestyle. I must be mature enough to be willing to accept that it is “ok” for us to “agree to disagree.” 

If you have strongly held beliefs, you will frequently find that you do not agree with people. The only alternative is to be a diluted milk toast with nothing strong or characteristic about you. You will have taken on being less of a human. You will have sacrificed a lot of the flavor and wonder of being a human. Please do not do this.

You should feel free to strongly believe, to strongly feel, and to live according to your conscience. You and I are then inevitably going to disagree. I am sorry about this. It is a little bit frightening to live this way, but it is much more exciting. It is much more real.

But please, let us tolerate each other. Would you be willing to let me follow my conscience as you follow your conscience? And in some moments, we might even be mature enough to dialogue about our differences and we might even learn from each other. We might help each other to grow. But please let us not insist that we must become each other. I may be right, and you may choose to accept some of my thinking. I may be wrong, and I pray for the maturity and the grace to be able to see this and accept it as it comes.

And this is where the surprise may come to many of you. 

Many of us with deeply held beliefs as Christians find tolerance much easier than others would ever understand. We silently tolerate lifestyle choices in those around us of substance use or abuse, sexual license, profanity, etc as a routine part of life in our world. These are choices that would break our consciences if we were to make them for ourselves. But for many around us who we consider friends, these things on a small scale are a routine part of their lives. We have learned the skill of remaining friends and yet not insisting that you think or live the same as us. 

When the more extreme examples come, it is easy to assume that we would of course object and adopt intolerance. But these are differences only of magnitude. The same skills that we have acquired throughout our lives of living, working, and being friends with people who make different choices then our own, makes tolerance much easier. 

I can take a sexual history and not be shocked anymore. When I discover that my female patient is biologically a male patient it is a surprise but does not mean that I will in any way not treat them with dignity and respect. I would personally not adopt that lifestyle. But I also would not adopt the lifestyle of the sexually promiscuous heterosexual patient that came before them. For some reason the promiscuous heterosexual patient seems more acceptable in our society.  But both are different than me. Both are my patients, and both are best treated with dignity and respect. 

I hope and expect to be treated with dignity and respect from you in spite of our differences. So also, I expect myself to treat you or my patients the same way.

This does not mean that intolerance does not exist. It is a big problem. But it comes from an expectation that everyone else must think and act like me. If I assume that everyone in the world thinks like me, I will struggle with intolerance. The problem comes when I view the world in rigid lines that are black and white. It is when I assume that there is a majority of “us” who are normal. In that scenario I can write off or reject anyone who does not neatly fit within “our” lines. But the world is so much more complex than that. With every other person in this world I will find areas where we will agree. It is also very likely that I will find areas where we will disagree.

This also does not mean that I can abdicate my responsibility when I see my friends or patients harming themselves or others. If I have a patient who continues to smoke, it is my duty to explain to them the harm they are bringing on themselves. But they often are surprised when I talk to them with an attitude of respect. I have found it does little good to scold them like little children. Instead I ask them to weigh out in their minds why they are choosing to harm their bodies. What is their motivation? I then can tell them that we won’t get anywhere until they are personally motivated to change. It really is their decision. This is inherently a different discussion than to bring in the “church lady” attitude and wave my finger at them.

What does this all mean?

  • I do not have to agree with you.  We can be ok with that.
  • Please treat me with tolerance when we do not agree. Please do not force me or expect me to mimic you. I cannot do it and should not do it.
  • I promise to try to treat you with the same degree of tolerance and respect.
  • Some days we might be bold enough to talk about our differences and learn from each other.
  • Most days we should learn to live and work and play together in peace in this imperfect world in which we live.
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Being human Reflections on Life, Being Human, and Medicine

How to Enjoy a Dinner Party

It was at a dinner party in Belgium. We were celebrating my aunt and uncle’s wedding anniversary. It was a great gathering of their family and friends. We were so pleased that we got to be a part of it. I was also pleased that most of the guests spoke English!

I was making casual conversation with one of their friends. I asked him, “So, what do you do for a living?” 

He answered me, “You must be American?” 

I asked him why he said that. He told me that Americans seem to be so fixated on work as their identity that it was a very American question for me to ask. He told me that a European would generally not ask that question. 

“So, what do you talk about?”

He told me that they might ask about what book they were reading, where they went on holiday or where they were planning to go on holiday. 

As the evening progressed, I learned that he was an engineer involved in designing how sound is handled in professional buildings. That was fascinating. I had no idea that was an entire line of engineering. But I also learned about where he went on holiday and what things interested him beyond his work.

The lesson has stuck with me.

Several months later I was at a professional dinner. It was at a weekend meeting focused on heart failure management technologies. It had been a long day and I really did not want to have the day’s work activities stretch into the evening over dinner. And so, I told the story about the dinner conversation in Belgium. Carolyn was sitting next to me. I asked her what book she was reading or had recently read. It started a great conversation. We talked back and forth about it for a while. She then asked me what I was reading. I explained that my daughter Dorothy loves Dostoevsky and that I was reading “Crime and Punishment” because of that. 

What followed was a wild journey! 

Carolyn also was a big fan. In fact, after college she had moved and lived in St. Petersburg, Russia. While she was there, she decided to follow the steps of Raskolnikov, the main character in “Crime and Punishment.” 

In the book, Raskolnikov counts his steps from where he was living to the place where he was going to commit murder. As the book progresses, he does commit the murder. In case you haven’t read it, I won’t tell you anymore and spoil it for you. It is a great book with amazing depth.

Anyhow, while Carolyn was living in St. Petersburg, she went to the place where Dostoevsky was said to have lived and to have based his story. She then followed the traditional walk from the book, counting her steps as she went to reach the site of the fictional murder. When she did so she entered the building. 

On the steps in the dark stairway she made a startling discovery. On the steps inside of the building where Rodion Romanovich Raskolnikov was said to have killed Alyona Ivanovna to steal her money, Carolyn found a dead body! 

WOW! SCARY!

What a story! I couldn’t imagine it, can you? Just being in Russia would push most of us out of our comfort zone. But then to be following the steps of one of the classic crime stories and then to stumble on a real live – or – that is “dead” body – is just amazing! You couldn’t make that story up! 

The body apparently was an unfortunate homeless person who had settled there for rest and had passed away of natural causes. But nonetheless it must have been a terrifying experience! I still can’t imagine going through what Carolyn experienced.  It was such an incredible experience for her. And it was so much more interesting of a dinner conversation than continuing to talk about the role of thoracic impedance measurements in determining heart failure decompensation! That dinner meeting suddenly had become something that I would remember for a long time.

A few years later Dorothy followed her passion and moved to St. Petersburg to study Russian. 

Sarah and I were pleased to be able to go with her to St. Petersburg at the start of her time when she was getting settled in. While we were there, I told them of this story. And so, we too found the places and we walked the “Crime and Punishment” walk, counting our steps as we went. It was a delightful time! We didn’t end up going into the building. And just in case you are curious, we did not find a dead body on our journey. But we did have a great time doing it!

Starting the Raskolnikov walk.

A casual dinner conversation can lead to so much! As you sit at a dinner party can you too be taken on an adventure? Can you learn things that you might not know from the people you are dining with? 

Through the years then my friends have taught me a lot. 

  • There is real value in listening as much as talking. Oddly, people tend to find you to be more interesting company if you listen to them rather than if you are constantly talking at them.
  • Others are generally a lot more complicated and interesting than you might think. Everyone has a story. Within their minds and their lives are things that you can learn from. You can learn something from everyone, and everyone can learn things from you. Take on the attitude of expecting to be surprised by people. 
  • You might need to draw people out a little bit. It might help to keep in stock some questions that you can use to get them talking.

Who are you? What interests you? What stories or experiences do you have within you that I might not know? We as Americans are often focused on our career and what is happening there. But there is a lot more to life than that. I don’t think it is wrong to talk about our work, but we should not stop there. 

  • What was the last book you have read and what did you think about it?  What surprised you or stretched you in that book? Why did you read it? Were you happy that you read it? Why or why not?
  • Where did you go on vacation? Tell me about that. What was the most interesting or memorable thing that you did on that vacation? Were there things that surprised you? 
  • What was your favorite vacation ever? Why?
  • If you could live anywhere, where would it be? Why?
  • Where would you love to visit? Tell me why?

I won’t confess to be an expert at this but the lesson from Belgium has stuck with me. 

Can you view your next dinner party as a grand opportunity? 

Can you learn from the people that you are seated with? Can you ask and listen and find out what interests them? How might they think differently from you?  Will you let them perhaps stretch you or surprise you? Will you be lucky enough to be taken on journey inside a dark stairway in a deserted building in St. Petersburg, Russia? 

There are treasures within the people around you that you can learn from. Everyone has a few stories that are worth hearing. 

So…  What books have you read recently? Or perhaps, have you read any good blog posts recently? 🙂