Category: Reflections on the Christian Life

Reflections from the scriptures or on what it means to me to be a Christian. My hope is to show that the Christian life is one which can and should be lived with personal honesty, intellectual rigor, and respect for others.

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Being human Medicine Reflections on Life, Being Human, and Medicine Reflections on the Christian Life Updates on my health

The Crossing and Lessons Learned Along the Way, Part 2: How to Survive the Night

This is the second in a series of posts about sailing across Lake Michigan. On October 4, 2019 we sailed 90 miles over 14 ½ hours making the trip from Holland, MI to Racine, WI. We were powered entirely by the wind. We sailed through the night planning to arrive in the morning. We set out on our journey at about 4 in the afternoon. All was good in the light of day. Watching the sunset was enjoyable as we sailed along. But then the darkness came. 

In sailing, and in life, the night can bring a lot of challenges. Everything is harder in the night. Problems loom larger. Solutions are farther away. How do you survive the night? 

We took turns on watch.   Rule 5 of the COLREGS states: “Every vessel shall at all times maintain a proper lookout by sight and hearing as well as by all available means appropriate to the prevailing circumstances and conditions so as to make a full appraisal of the situation and of the risk of collision.”  This means that you need to keep someone awake and looking for other boats.

Every couple of hours we would rotate who was on watch. Most of the time the autohelm was running. All that was necessary was to ride along and watch for other boats. I have an AIS (Automatic Identification System) attached to my GPS/Chart plotter. All commercial vessels are required to electronically transmit their identity, location, speed and heading. This information will show up on my chart plotter. I turned on an alarm so that any vessel coming within a mile of us would sound an alarm. This is a nice safety feature.

It was a dark, cloudy, moonless night. The cool October air was chilling me. I started the evening in a long sleeve t-shirt and a light jacket. By the time of my middle of the night watch, I had put on every coat that I could fit. The air was cold, and the wind whipped around me. I had on 4 layers plus heavy gloves and a hat. On top of this was a Cat 5 life-vest and safety harness. Hooked to that was a tether connecting me safely to the helm. Jim and Joel were below trying to get some sleep. It was very dark. I could see the green and red shadows from the bow lights and a dim glow off of the chart plotter but not much else. I couldn’t see the water or anything around the boat.

All alone in the middle of the night in the pitch dark you can begin to see and hear things. I saw lights. Strange and fleeting lights would appear. Sometimes I thought I saw police or fire strobes. At other times, I could swear there were other boats that I saw off of our bow. One minute I would see what I thought were their navigation lights and then the next minute I would not.  I would check the chart plotter for any AIS data. No boats were indicated. It was eerie and strange.  The lights would appear and then disappear, likely the result of some strange refraction of light off of the overlying clouds. We were all alone in the middle of Lake Michigan. There never were any boats there. But at times I was sure I could see some.

I heard things. This was perhaps even more disturbing. All alone at 3 am in the pitch-dark night I was surely hearing things that I shouldn’t have. Without an engine running to drown them out, the sounds were more evident. There were, of course, the creakings and sounds of the boat, the sails and the rigging. But in the quiet, dark, and alone moments I heard other things. I could swear I heard a child talking. The voice was just off of the side of the boat.  It sounded like it was just 10-15 feet away off the starboard side of the boat. What was it? I would strain my eyes, but everything was black. I couldn’t see anything. And then I wouldn’t hear it anymore. I would laugh to myself. Of course, no one was there. Right?

I have read many of the wild stories of the sea. Sailors have claimed to hear all sorts of things. In the dark, deprived of sight, you begin to focus too much on the sounds. I suspect it was likely just the wind and the waves and the fatigue in my brain. Wasn’t it?

There is such a thing as too much focus. Obsessing can cause a loss of objectivity. There are those games where they show you a picture which is zoomed in really close on an object. Zoomed in too close you cannot tell what it is. The irony is that the harder you look the more likely you are to get confused. The truth can be lost in those moments of obsessive focus. It is only after you pull back the zoom that you are able to again see everything in perspective. When you pull back and relax your focus, then things become clear again.

We must beware the deceptions of obsessing. Kate Bowler[1] is an amazing author and speaker. She is a historian at Duke Divinity School. JJ has been working on her staff. At a young age and as a young wife and mother she was diagnosed with incurable metastatic colon cancer. The irony is that this diagnosis came in the middle of her PhD studies on the prosperity gospel. As she faced an enormous personal challenge, she was plopped in amidst people telling her to “just have faith” or to “name it and claim it.” She has developed a powerful message of truth and reality that goes beyond platitudes of optimism and positive thinking. In her words you can see a faith that is not naïve, but which is intensely honest, strong and real.

Kate Bowler has a rule that she cannot deal with anything serious or sad after a certain hour in the evening.  It doesn’t do any good. You don’t really solve the problems staying up all night to worry about them.  There are times when you just need to rest.

I am someone who has lived his life by solving problems with his mind. But some problems cannot be solved just by thinking about them. Cleverness can only get you so far. In the middle of the night, when things are silent, it is possible to focus too hard. In the middle of whatever storms or darkness life brings, sometimes the wisest thing you can do is to not try to solve everything. Whether it is the physical night, or a more figurative night, there are times when you need to just sit back and let the boat sail on.

In those dark and quiet moments, the wind can sound like a child talking. There is no child there. But the harder you listen, the more convinced you become that you hear him. The darkness can make your thoughts go places that are not real. You become unable to be objective. You cannot solve everything. Maybe in those moments you cannot solve even anything. Maybe you shouldn’t try. Instead you should just sit back and let the boat carry you. You don’t have to figure everything out or understand everything. The boat is doing the work. The autohelm is programmed and set and is following the course. Whether you understand or not, you will be carried forward. There are times when you need to just “be.”

On call in the hospital at night I learned a similar lesson. In the middle of the night, problems would seem enormous and unsolvable. I would look and think and dig and try to find solutions. It has always amazed me how the “middle of night problems” will consistently melt away in the morning. With daylight and the rest of the team returning, the enormous problem of 4 am becomes more easily solved. All becomes well again. Time and daylight can be our friend.

An abnormality on my CT scan pulls me into the night again. There is no answer other than that I need to wait and watch. I desperately tried to find an answer. I went back to the ACC (adrenocortical carcinoma) Facebook groups. I searched and read other’s experiences. I tried to pull them into my situation. I went onto PubMed and into the medical literature. I tried to somehow find answers to what those two lymph nodes could mean. 

In the dark, the harder I tried to find information the less I knew. My obsessive focus was not helpful. Later came the answer from the tumor board and then Dr. Hammer. The nodes may or may not mean anything serious. We just need to wait and look again in 3 months. The right thing to do is nothing. I need to settle down and just sit back and sail on. The Lord knows my future and at the moment my course is clear. Wait. I don’t have to know any more than that. 

The child was talking again just off of the starboard bow. I shined my handheld floodlight off at the dark waves. There was no boat. There was no child. There was just a vast large lake all around us. I laughed at myself. “This will make for a nice story someday!” I told myself.

The Lord is in charge. He has a course plotted out for me. I am comfortably in His hands. The best thing for me to do is to sit back and let time carry me along. Knowing or not knowing will not change my present or my future. Sometimes stray thoughts will come. In the night, when I am tired, it is ok to hear them and then ignore them. Maybe I can even laugh at myself and think, “This will make for a nice story someday!” 

Kate Bowler is wise. The nighttime is not the time to solve things. There is a time when you should not think or talk about serious or sad things. Give yourself a break. Put the thoughts away for the evening. You can pick them up tomorrow. 

Peace child. Be still. The daylight will come in the morning. Wait for it. You can work on or think about everything then. For now, just sit back and let the waves and the wind rock you back and forth and be calm.

[1] https://katebowler.com/books/everything-happens-for-a-reason/

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

A Desk and a Chair, a Feeling, and the Future

I drove by Blodgett Hospital yesterday. I was shocked to see that they tore down the parking structure that was attached to the professional building. The garage was old and failing but to see the hole in the ground was a shock. It brought back memories. Oddly, the memories felt good. They brought a light of sunshine and warmth inside of me. 

Let me explain.

The year was 1998. I was walking through that parking garage. From the garage I could see the windows for the physicians’ offices for Grand Valley Internal Medicine. I was finishing my internal medicine residency. I had accepted a job as a new primary care physician. I could see my desk and my chair. It was an exciting feeling to have that be my desk and my chair. It was exciting to tangibly see a future. 

I remember coming into my office for the first time. I had the keys to the back door for the office.[1] My office was empty except for the desk and chair. It felt really good. It was a place for me. It was more than that. This was where I was going to settle. This was where I was going to be able to see patients and work. It was where I was going to have a future.

I worked in that office for about 4 ½ years. They were good years. The practice itself was something that I will forever be proud to have been a part of. The doctors were truly excellent clinicians. I could tell anyone where I worked  and then just mention the names of a few of the doctors and immediately I would gain their respect. “That is a great office!” they would say. From the start there was a steady stream of patients. The patients and their problems were wide and varied. They challenged my internal medicine skills. They grew me and completed me as a physician.  

When I left it was not because I didn’t love the office, my colleagues, the staff or my patients. It was a hard thing to leave the office. But then there was something else. There was a drive inside me that made me leave. It was an intense sense of purpose. It was a need to be focused – to be a specialist.  I needed to be someone who could contribute in his own way – in his own niche – to the community. I have never regretted leaving. But I still love that practice. And I loved that office and that desk and chair.

As I continued to drive home yesterday I tried to understand why I felt the warm and nice feeling inside. A few minutes before that I was feeling frustrated and stressed. I had COVID 19 stress pulling at me. But a glimpse – and then a thought – could in an instant – cheer me up. 


Why?

I think it was the memory of being young and enthused and with a future. 

It was just an empty desk with a chair. But it was a nice desk and a nice chair in a carpeted office with a window (even though it viewed the parking garage.) It was just a desk and chair but so much more than that. It was my desk and chair. It was a place for me. It was opportunity for me. It was a future.

I think now that the warm feeling is about “hope.” It is about looking forward. It is about not staring at and indulging in the pain of now. It is about not obsessing over the problems or failures or anxieties of the past. It is about looking forward to what is next. It is creating a plan and marching forward. 

It is getting the new school clothes with the tags still on them and with the new smell to them to be ready for another year of elementary school. It is the new lunch box complete with a plastic Snoopy thermos. It is going to the college bookstore the month before classes start to buy your books. It is moving into the apartment in a new city and making your bed for the first time and learning your way around. It is the scary first or second or third dates – scary but filled with excitement and dreams of what the future could be with that person. It is getting out of the moving truck and walking around your new empty house with your spouse looking for where each piece of furniture will go.

Dear Lord, please help me if I stop having a future. There must always be a future. 

I am not saying that it won’t be without some anxiety. 

Starting as a brand-new primary care physician meant that I had a lot to learn and do. I did not have years and years of practice patterns to guide my decisions and work. I had to figure out how I as a physician was going to handle each diagnosis and medical problem. Every day brought new challenges and new things to do. It was heavy lifting. I worked hard. It wasn’t easy. 

Our futures now are not easy. 

We are looking at how to navigate another year or two of COVID 19. We are looking at how to live in a world with social distancing and face masks and obsessively using hand cleaner and anxiety and worry about who might get seriously ill. We have all the arguments and all the uncertainty about how we move forward. We have so many questions and unknowns.

Many have lost their jobs and are not sure where to look next to find another. 

Many of us are working in distressed health systems. We are looking at working with a lot fewer support staff and pushing ourselves to work harder. We are figuring out how to go back to work and to see more and more patients. We feel a drive to deliver more care so that not only can we help our patients who need it but also so that our health system can dig out of the revenue hole that COVID 19 has created. 

There is a lot of uncertainty and a lot of work ahead. 

But this morning the trees in our back yard have budded out with new leaves. They are rapidly closing in our back yard again with their lush green just like they do every spring. They have not frozen in place in anguish. Summer is coming. There is a future.

We are not the first to live through a lot of changes. 

I think of the ancient Israelites who were carted into captivity in Babylon. Imagine being conquered by an enormous army and being dragged away from your homes. What should they do? How were they going to survive? 

In that setting the prophet Jeremiah spoke these words from the Lord God Almighty, “Build houses and settle down; plant gardens and eat what they produce. Marry and have sons and daughters; find wives for sons and give your daughters in marriage, so that they too may have sons and daughters…”[2]

I think you get the idea?

He continues later in the passage, “For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”[3]

One of my teachers gave me a gift with that verse on it when I graduated from high school.  I didn’t really understand what it meant. I do now.

The desk and the chair are all about having a future.  We may not know what the future will be. It likely won’t be easy. It can and will create anxiety inside of us. It will mean changes and new things. It will push us to learn and grow. But now is not the time to stop. Now is the time to get up and live.

But what does that mean? 

To paraphrase the prophet Jeremiah: “Figure out what you are going to have for dinner. Later get a good night’s sleep. Get up the next day and think about what work you can or want to do. Look for opportunity. Look for what is next. Love your family. Live your life. Raise your kids. Be excited as they too live their lives. Look to the future.”

Last night I went from feeling frustrated and anxious to feeling warm inside. Then and in this moment I remember the feelings I had when I first looked at that desk and chair. They are good feelings. They are exciting. In that memory, I am okay. I can feel warm and good. 

I can and will look to the future – whatever it may bring.

[1] https://manmedicineandmike.com/he-has-the-keys-to-the-back-door/

[2] Jeremiah 29:5-6, New International Version

[3][3] Jeremiah 29:11, New International Version