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

Music

I was invited to be part of an honors band. I was in high school. As I recall, it was a weekend event held at Albion College. There were a few of us who went. I played the cornet. 

The event included rapidly learning a piece of symphonic music along with students from around the state of Michigan. We learned, practiced, and rehearsed.  The culmination of the event was a concert where we performed.

It has been so long ago (over 35 years ago) that I don’t exactly remember all of the details.

But I do remember the feeling. 

The performance was amazing. Sitting in the middle of the large band with some really talented musicians was an honor and a joy. In the performance the music seemed to lift me off of my chair. I remember thinking that the sound from French horns around me was close to heaven. I could feel my inner self being moved in ways that I cannot completely explain.

For a scientific mind it was one of my early tastes of the joys of the other parts of my existence. I have always found the logic of science easy. Math was truly enjoyable. It has structure and rules to it. It is reproduceable. You can follow the rules and get the same answer every time. Once you understand the principles you can get the right answer. And there is always one right answer.

Life is not always that way. There are of course parts of life that are indeed objective and reproduceable. But then there is art. And poetry. And music. And really understanding people. And the reality of living in a world that is not always black and white.

These are a lot harder for me.

As I have aged, I have come to appreciate the complexities in life. Many of us begin to say that we realize that there are multiple gradations of gray in between the black and white.  

But that is not the real truth. 

The real truth is that there are rich and vibrant colors that fill our universe. 

Of course, everything is not black and white. There are colors that I don’t even know how to name. Colors that fall somewhere in between. Colors that we don’t even know if we all experience in the same way. Colors that can invoke deep emotions – sometimes exciting, sometimes happy, sometimes sad and sometimes serene. Pastels. And bright colors. And muted colors. And quiet and subtle grays.

I still tend to be more concrete when it comes to art. I favor a good traditional landscape. And for writing I favor something logical. Poetry can baffle and frustrate me. But at least I hope to think that I am closer to knowing what I don’t know. Maybe I don’t have to find clear and concise logic within the painting or the poem or the story or the music. 

Maybe it is all about helping me understand that we are complex beings as humans. This is a far more complex universe and existence than what we can verbalize. We are not just chemicals and biological organs. There is something far more profound and deep to our existence. There are levels of complexity that cannot be explained by a scientific mind.

There is the immense joy of sitting in the middle of a symphonic band and feeling deep deep emotion welling up inside of me. The emotions are so intense that at one moment I can feel both joy in my heart and tears welling up in my eyes. And these seem to come from a place that I cannot explain. 

In that moment I understand that there is a lot more to being human than I will ever understand. In fact, there is far more to our world – to our universe – than what is obvious. 

Our good friends perform in the Grand Rapids symphony. I saw that the symphony was going to perform Holst’s “The Planets”. Like many I have always loved that symphony. The intensity of the music is strong enough that it can bring me back to what I felt sitting in the middle of the honors band at Albion College. Sarah talked with our friends and as a present to me got tickets for us to go to the performance. 

It was amazing. It once again moved me in ways that I cannot explain.

What was fun was that it did the same thing for Sarah. She was amazed by it. We walked away not sure what to say. You cannot explain it in words. All you can say is, “Wow!” 

And in that moment, you get a glimpse of how wonderful and amazing and complex our existence is. An existence which God has created with depth and beauty and complexities that go beyond our understanding. 

Do not forget music. Indulge in it. Enjoy it. Turn off the television. Go to the symphony. Sit in the middle of the auditorium and let the music wrap around you. Tone down your left (rational) brain and let the music work inside of you. Let it play with your emotions. Let it move you to places that you were not expecting or cannot rationally explain. Let it teach you about being fully human. 

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

Dependency

He has a terminal diagnosis. It is taking him slowly. No one can know how long he will last. It is weakening him and that is hard for him.

It was a routine clinic day for me. I was bopping from room to room working through my day trying to keep on time. I hate being behind in clinic. I keep pushing to get my notes done between patients. I rapidly scan the chart for the next patient. I see that he was recently hospitalized. In the hospital he didn’t respond very well to the treatment. He is home now but it doesn’t look very good for him.

When I enter the exam room seeing his face “clicks” something in my mind. I am a visual learner. Seeing him and his wife helps me remember a lot about him. He is a big and muscular man. He is the type that has always been strong in both body but also spirit. He is the type of person that you could rely on to always be there and to always get everything done.

He looks different now. He is clearly being weakened by his disease. His color is not good. It is still him, but it is as though the battery has been partly drained. The strong muscles are not getting the energy they need. This is going in the wrong direction. As his doctor, I do not have a thing that I can do to alter that.

I tried to engage him in a goals of care discussion. I don’t think that the hospital will ever be a good place for him. It won’t help him. It will likely just weaken him even more. If we are smart, we would keep him in his home. I honestly think he will live longer if we don’t ever put him in the hospital again. 

If we don’t talk about this proactively the hospital is where he is going to end up. That is the default and easy pathway in the U.S. It amazes me how it is always so much hard work to fight against that. Every time it is heavy lifting. I think – for him – this may be the most important thing that I can do today.

What does he want? What are his goals? What are his fears? What would be an unacceptable outcome for him?

He doesn’t want to be a burden on his family. He will want to be hospitalized purely so that they don’t have to take care of him. His wife was shaking her head firmly. She has no problem taking care of him. I know that we can get hospice or other home care resources to him. Even so he doesn’t like the dependent role that he was been forced into.

It has become clear that this is about so much more than just whether or not he wants to be hospitalized again. It is about how to accept and handle dependency on others. He is not wanting to talk about it, but he needs to. His wife knows it. I know it. And deep down he knows it.

I cross the line and start talking about my cancer journey. They knew I was off on a medical leave. They didn’t know why. I explain it to them. I then take it further and talk about some of the lessons. I talk about what it meant to me to be a man. I had strength. I had stamina. I could push myself. And then I could push myself more. I could work late. If I couldn’t get things done at night, I would secretly set my alarm earlier. It could even be extreme if need be to get the job done. I could and I would shoulder the responsibility for whatever I needed to get done. Sleep was good but I could sacrifice it at will to meet the needs of my work, my family, and my life. Sleep was the margin that I could and would sacrifice.

I told him that this was who I was. He nodded and tears formed in the corner of his eyes as I could tell that we were connecting. This was who he had been. 

But no longer.

Shortly before my surgery I lost my stamina. Perhaps it was the tumor. Perhaps it was the stress. I couldn’t keep up the pace anymore. The surgery was staggering to me.  It was enough to roll over in bed, let alone do anything physical. Radiation continued the story. Chemo turned it from a short story to a novel. 

I told him how my wife insisted on driving me to my radiation appointments. I thought I could go alone. She insisted that I not.

He and his wife started nodding. I had struck another point of agreement and understanding.

I told them how we are in this life together. As much as I wish I could be the man that I was before it was not intended to be. I told them that I believed my Lord had forced me into dependency. Sarah and my family and friends and colleagues needed to take care of me. I needed to accept having others do things. I had to accept the role of dependency.

I told him it was ok. His years of strength and serving and supporting his family were wonderful. In this chapter if he needed to have the roles reversed it was ok. He didn’t have to like it. But his wife and his children needed to take on supporting him. 

JJ and Sarah trying to cut the Christmas tree for me while I was recovering from surgery. So maybe they were not very good at it!

I told him that his wife and children too were being traumatized by his illness. They have been forced into a feeling of helplessness as they watched him fading. They were desperate to do something to help. In their grief they needed something physical that they could do. The energy that they exerted helping him was the only tangible means that they would have to fight. His willingness to let them come and help him was a gift. He needed to understand that as the leader of his family he needed to help them to be able to grieve. His illness was calling him to do something hard.  

He had to let others serve him. He had to accept dependency.

It was ok.

By now, the tears were evident in his eyes. He understood. I understood. We didn’t have to like it. But as strong men, we can and would do whatever was best for our family.

The doors were now open. We talked about home care services. We talked about hospice. We talked about continuing to endure – to work to stay alive – for now – if that is what was best. We talked about the inevitability of death for every one of us. “A recent study has shown that human mortality is close to 100%” We laughed. Then we talked more.  In his case now, we talked about the important questions of “how” and “where” rather than “if” or “when”.

I didn’t really change much in terms of his medicines. But I like to think I was a good doctor. I provided the treatment that he desperately needed. 

Thank you, Lord, for letting me be your servant in the exam room this last week. Thank you for letting my cancer journey be used for good. It makes it just a little bit better if it could do some good. It is not that I wanted the cancer. But at least, in that moment, it was good.