Emerging Scholars Blog

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redemptive healthcare

Rituals of Annotation

My tally marks. Kyrie eleison.
My tally marks. Kyrie eleison.

I am not exactly sure of what prompted me to do it, but I began keep­ing a tally of all the pro­nounce­ments I have done. A pronouncement is that act in which a doctor officially declares a person to be dead. Some deaths are theatric spec­tac­les involving beep­ing mon­i­tors, electric shocks, and crack­ing chest car­ti­lage. These tend to be chaotic, gritty, and conclusive as in the TV shows, sometimes ending with a dis­traught physician intoning, “Time of death. . . .”

However, most pro­nounce­ments done in the hospital are remark­ably simple and imper­sonal. Because we attach so much meaning to death and have sequestered it far from the public eye, we are conditioned to believe that its act must be as spectacular and monumental as its significance. But what usu­ally hap­pens is that the per­son will merely expire, often with nothing more than a quiet, gasp­ing sigh. It is usually expected but spontaneous, with a somber but quiet family waiting aimlessly for the event to occur. Some­times hos­pice arrange­ments are made for the patient to go home to die, sur­rounded by fam­ily and friends. Some­times a volun­teer in the hos­pi­tal will keep a vigil of sorts, sit­ting in a chair while read­ing a book or watch­ing TV as he or she does the job of those who have no family, waiting to ful­fill the simple courtesy of not letting any­one die alone. Some­times a nurse will make the rounds and dis­cover that the patient has passed in the few brief hours in between visits. Regardless, those final moments occur at any hour and in any floor of a large hos­pi­tal like mine. In every case, when­ever the death is dis­cov­ered, a page is sent to whichever res­i­dent is on call to stop by and make the offi­cial pro­nounce­ment. [Read more…] about Rituals of Annotation

The Pursuit of Suffering

Bone marrow aspirate showing acute myeloid leukemia. Several blasts have Auer rods. Original uploader was VashiDonsk at en.wikipedia.

I watched the grainy, blocky video in silence. My friend was singing “Land­slide” and I felt a cer­tain taut­ness in my eye­brows and a pecu­liar heavi­ness in the cor­ners of my mouth. By now it had become a famil­iar feel­ing, this phys­i­cal expres­sion of sorrow.

Can the child within my heart rise above
Can I sail through the chang­ing ocean tides
Can I han­dle the sea­sons of my life?”

~Fleet­wood Mac, “Land­slide,” The Dance, 1997

Sonia Lee ’06, whose mel­low and res­o­nant voice was cap­tured in that video, passed away in 2007, during my second year of medical school. For most of our mutual friends at our college Christian fellowship, her pass­ing became our first encounter with the death of a friend. In many ways, it chal­lenged my most deeply held con­vic­tions about the way the world works. I went to med­ical school with the grow­ing con­vic­tion that my call­ing was to deal with death and suf­fer­ing on the pro­fes­sional level, but this experience — so unex­pected, tragic, and ter­ri­fy­ingly personal — cast every­thing under a dif­fer­ent pall.

Sonia had acute myeloid leukemia. The onset was rapid and com­pletely unex­pected by friends and fam­ily alike. I can still remem­ber the dread of the moment I first found out: a string of e-mails with the titles “Urgent prayer for Sonia…” wait­ing qui­etly in my inbox. Sonia and I had been good friends dur­ing our under­grad­u­ate years but had fallen out of touch since my grad­u­a­tion two years prior and I had not heard much from her since then, which made the sud­den­ness and feroc­ity of the dis­ease all the more shock­ing. A full year in med­ical school did noth­ing to pre­pare me for the daily anx­i­ety of open­ing my e-mail in antic­i­pa­tion of an update from the fam­ily on her con­di­tion. I still have all those e-mails: seventy-seven mes­sages with head­ings rang­ing from “A pos­i­tive turn for Sonia!” to “Sonia — Chemotherapy day 3” and “Emer­gency request for platelets.” [Read more…] about The Pursuit of Suffering

Introductions: Dissection of body and soul

By definition, medicine must bridge the most vexing dichotomies and paradoxes of our modern world: life and death, suffering and healing, spirit and body, science and faith.

Medical school is mostly boring and the parts that are not are often tragic, which is why few people write about the experience.  Prospects facing newly-minted residents and attendings are not much better, as the overwhelming secularization of a discipline once seen as divine has fueled financial exploitation, divisive politics, and increasing frustration, cynicism, and disillusionment in those who once sought something more meaningful.  While there have been exponential gains in scientific understanding and treatment achievement, changes in “medical ethics”, malpractice, and medical culture have also surpassed the average healthcare provider’s ability to make meaningful and humble sense of the world.  As a result, not only has healthcare lost much of its posterity, austerity, and integrity in our post-post-modern culture, but it has coerced Christians into a defensive and embattled posture, in which they feel it is all they can do to simply be Christian and a physician, much less a Christian physician.

However, Edmund Pellegrino, founder of modern medical ethics and a Christian himself, once said, “Medicine is the most humane of sciences, the most empiric of arts, and the most scientific of humanities.”*  By definition, medicine must bridge the most vexing dichotomies and paradoxes of our modern world: life and death, suffering and healing, spirit and body, science and faith.  If it is to be of any value, it must make the transition from “benchwork to bedside,” across ever-widening socioeconomic gaps, and from sorrow to joy.

In short, the new nature of Redemptive Healthcare must be willing to and capable of adopting an innovative stance, again bridging seemingly disparate and conflicting forces with the counter-intuitive truth of the Gospel: that Jesus Christ, who was in very nature God, became a man and humbled himself to death, even death on the cross. . . . and that through that death we have forgiveness, healing, and resurrection.

In anticipation of the Lenten season and Easter, I would like to share a series of reflections on death and resurrection as played out in my journey through medical school and residency.  The first of these begins with a reflection given at my medical school’s Anatomy Lab Memorial Service, where medical students gather annually to humbly thank the friends and families of the cadavers who donated their bodies to the dissection lab.  I hope it resonates with those of you who have struggled to find some human connection to the theoretical work that takes place in your own laboratories, offices, and centers for learning and Gospel. [Read more…] about Introductions: Dissection of body and soul