CMDA Today - Winter 2022

CMDA TODAY

Volume 53 • Number 4 • Winter 2022

Embrace

RECOVERY

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From the CMDA President T. Lisle Whitman, MD

A Reflection on CMDA

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n 1990, my wife Lauren and I moved to Charlottesville, Virginia to begin our medical training. One of the first events we attended was a CMDA kickoff cookout hosted by the venerable Dr. Lewis Barnett. At that event, I also met one of my most significant life mentors. While there, I picked up a little trifold brochure that would make a profound change in the course of my life. The CMDA Statement of Faith printed on the back of that brochure made a powerful impression about this group of Christian healthcare professionals. Since that time, I have had the opportunity to participate with CMDA in countless wonderful experiences, and my life journey has been greatly enhanced by this organization. As my presidential term draws to a close, I am taking a little trip down memory lane.

What really drew me to join CMDA? I was a newly married medical student desiring a competitive residency. It did not seem I had a lot of time on my hands for extracurricular activities. While the Statement of Faith confirmed this was an organization I could support, what CMDA offered to make it worth our commitment was fellowship and the opportunity to associate with fellow believers on this journey. To me, that is the essence of what CMDA remains today. As an association of healthcare professionals with a commitment to living out the tenets of Christ in our calling, we have the opportunity to change lives individually and corporately.

Individually, CMDA facilitates relationship among Christian healthcare professionals. As with most of you, my involvement started on the local level. Weekly student Bible studies allowed me to keep my faith vibrant as we shared with one another.

My local CMDA community placed me in relationships that pointed the way forward and gave sound advice on my many questions. Lauren found relationships that gave her wisdom and insight into this beast called “medical marriage.” Over time, becoming involved in leadership gave me more opportunities to interact with fellow believers. When I consider the numerous relationships that exist only because of CMDA, I am amazed. I am a better husband, father, physician and businessman because of the truth poured into my life by CMDA members. I know my experience is common to many of you as you have walked through your professional career.

national organization providing support to those early meetings. Currently we facilitate more than 300 groups across the country, groups just like the one that made such an impact on me. We provide educational materials and leadership training for those engaged in community ministry. CMDA also offers cross-cultural healthcare mission trips (through Global Health Outreach and Medical Education International) that have made a difference in so many of our lives, not to mention the places the gospel has gone that would otherwise have remained dark. CMDA Tours open the Bible by taking us to where it happened with amazing biblical teaching. CMDA continues to leverage our membership to become a voice crying in the wilderness of advocacy and public policy. Together, all of us have won court victories that preserve our right to apply our conscience in how we care for our patients. We stand for the unborn and others unable to defend themselves against the crush of our current political environment. When Alliance Defending Freedom or Becket Law need an ally in religious freedom cases, they often look to the healthcare professionals of CMDA. It is hard to believe I have been a member of CMDA for more than 30 years. I am so grateful for the truth CMDA pours into my life through the relationships it continues to foster. As I wrote this letter, I mentally replayed countless friendships, activities and conversations that span those decades. God has used CMDA as a channel to deliver manifold blessings into my life. To those who have gone before me, thank you for making this possible. To those who come after, may CMDA continue to enhance your ability to serve others through the passion of healthcare.

T. Lisle Whitman, MD, is the 2021-2023 CMDA President. He is an orthopedic surgeon in Bristol, Tennessee, and he has practiced with Appalachian Orthopedic Associates since 2000. Lisle and his wife Lauren have three children, one daughter-in-law and three grandchildren.

He loves the practice of general orthopedics. He has participated in several overseas mission trips, and he enjoys family trips, the lake and learning new things.

Corporately, CMDA leverages our membership to make a difference around the world. This is the part I never considered when I signed the back of that little brochure more than 30 years ago. I now appreciate the power of our organization in numerous arenas. Behind our local CMDA group, there was a

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VOLUME 53 | NUMBER 4 | WINTER 2022

EDITOR Rebeka Honeycutt

EDITORIAL COMMITTEE Gregg Albers, MD John Crouch, MD Autumn Dawn Galbreath, MD Curtis E. Harris, MD, JD Van Haywood, DMD Rebecca Klint-Townsend, MD Debby Read, RN

CMDA TODAY

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CMDA Today™, registered with the U.S. Patent and Trademark Office. Winter 2022, Volume LIII, No. 4. Printed in the United States of America. Published four times each year by the Christian Medical & Dental Associations® at 2604 Highway 421, Bristol, TN 37620. Copyright© 2022, Christian Medical & Dental Associations®. All Rights Reserved.

Distributed free to CMDA members.

Non-doctors (US) are welcome to subscribe at a rate of $35 per year ($40 per year, international). Standard presort postage paid at Bristol, Tennessee.

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CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS P.O. Box 7500, Bristol, TN 37621 888-230-2637 main@cmda.org • www.cmda.org If you are interested in submitting articles to be considered for publication, visit www.cmda.org/publications for submission guidelines and details. Articles and letters published represent the opinions of the authors and do not necessarily reflect the official policy of the Christian Medical & Dental Associations. Acceptance of paid advertising from any source does not necessarily imply the endorsement of a particular program, product or service by CMDA. Any technical information, advice or instruction provided in this publication is for the benefit of our readers, without any guarantee with respect to results they may experience with regard to the same. Implementation of the same is the decision of the reader and at his or her own risk. CMDA cannot be responsible for any untoward results experienced as a result of following or attempting to follow said information, advice or instruction.

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ON THE COVER EMBRACE RECOVERY A Time to EMBRACE Recovery

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The Season of Light Around the World Doug Lindberg, MD

Darren Caparaso, MD

Building a Foundation to Recovery

avid Holmes, MD D ow God is using the healthcare community H and the church to face the opioid epidemic

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Healing from the Violence of Busyness: Five Biblical and Theological Reflections on Time and Work Emmy Yang, MD, MTS

Applying what we learn from Scripture to overcome weariness at work

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Your Body Will Be Whole: Meditations on Heaven

A look at the sights and sounds of the holidays from the mission field

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The Dr. John Patrick Bioethics Column Losing Our Language to Bureaucratic Jargon John Patrick, MD

How to educate ourselves and our patients in the language of ordinary human beings

See PAGE 34 for CLASSIFIED LISTINGS

Kathryn Butler, MD

Redeeming our hope in Christ and not in this world

REGIONAL MINISTRIES

Connecting you with other Christ-followers to help better motivate, equip, disciple and serve within your community Western Region: Wes Ehrhart, MA • 6204 Green Top Way, Orangevale, CA 95662 • 916-716-7826 • wes.ehrhart@cmda.org Midwest Region: Allan J. Harmer, ThM, DMin • 951 East 86th Street, Suite 200A • Indianapolis, IN 46240 • 317-407-0753 • cmdamw@cmda.org Northeast Region: Tom Grosh, DMin • 1844 Cloverleaf Road • Mount Joy, PA 17552 • 609-502-2078 • northeast@cmda.org Southern Region: Grant Hewitt, MDiv • P.O. Box 7500 • Bristol, TN 37621 • 402-677-3252 • south@cmda.org

THE CHRISTIAN MEDICAL & DENTAL ASSOCIATIONS ® Changing Hearts in Healthcare . . . since 1931.

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Ministry News RESOURCES

New CMDA Today Editor CMDA is excited to welcome Rebeka Honeycutt as the new editor of CMDA Today, our quarterly publication. Rebeka recently joined the Communications department to assume responsibility for producing the magazine, which includes coordinating authors and articles, writing, editing, assisting with graphic design and layout, working with vendors—generally managing the magazine production process. In addition, she assists with other projects within the Communications department, including editing, media relations and advocacy initiatives.

Rebeka joined CMDA in 2020 to serve in CMDA’s Member Services and Continuing Education departments. In addition, Rebeka holds a bachelor’s degree in business leadership from The Baptist College of Florida. A native Floridian, she relocated to North Carolina for a few years before marrying her best friend Carter in 2021 and moving to Bristol, Tennessee. She enjoys books, podcasts, decorating, volunteering and repeatedly viewing her comfort shows and movies. She is known for baking pound cakes and is happiest near any beach.

To contact Rebeka, email rebeka.honeycutt@cmda.org or call 423844-1071.

CMDA Learning Center The CMDA Learning Center offers complimentary continuing education courses for CMDA members.

This online resource is continuing to grow with new courses to help you in your practice as a Christian healthcare professional.

More than 100 hours of continuing education are now available at NO COST to CMDA members. For more information and to access the CMDA Learning Center, visit www.cmda.org/learning.

CMDA Matters Are you listening to CMDA’s podcast with CEO Dr. Mike Chupp? CMDA Matters is our popular weekly podcast with the latest news from CMDA and healthcare. A new episode is released each Thursday, and interview topics include bioethics, healthcare missions, financial stewardship, marriage, family, public policy updates and much more. Plus, you’ll get recommendations for new books, conferences and other resources designed to help you as a Christian in healthcare.

Listen to CMDA Matters on your smartphone, your computer, your tablet…wherever you are and whenever you want. For more information, visit www.cmda. org/cmdamatters.

Faith Prescriptions CMDA Go App Have you downloaded CMDA Go yet? Our mobile app, CMDA Go, is now available to download on Apple and Android mobile devices.

Visit your device’s app store to download it today.

In the CMDA Go app, you can set up your personal CMDA profile, check out the latest news from CMDA, listen to CMDA Matters and other podcasts, renew your membership and make your dues payments, access a variety of downloadable resources, interact with other members through the discussion forms and join group chats.

For more information, visit www.cmda.org/app.

New to the resources provided by CMDA is a new video series called Faith Prescriptions. This 25-part video series (featuring 10 core sessions) provides training on everything from LGBTQ issues in the healthcare arena, to praying with your patients and sharing your faith in ethical and appropriate ways with colleagues and patients.

Faith Prescriptions is a revision of the program Grace Prescriptions, which has been in circulation for several years on DVD. But this new, updated and improved series will be video-on-demand. It is free to CMDA members and simply requires your member login and password to access all sessions, as well as all video training sessions, within the CMDA Learning Center.

Get started today by visit www.cmda.org/learning.

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Ministry News

Bridging the Gap

Remedy23

As Christians, we are called to speak truth into ethical issues and courageously stand up for what’s morally right according to our beliefs. But in order to engage others in these discussions with grace and kindness, first we need to arm ourselves with knowledge and understanding of each of these topics.

Bridging the Gap: Where Medical Science and Church Meet is a new small group study developed by expert healthcare professionals on CMDA’s Church Commission. The curriculum is designed to ask difficult, thought-provoking questions as we seek the truth found in God’s Word about the ethical issues facing Christians today. Topics include addictions, beginning of life, end of life, gender identity, right of conscience and sexuality.

For more information and to download the curriculum, visit www.cmda.org/bridgingthegap.

Are you ready to live missionally as a healthcare student, trainee or professional? Join us for Remedy23: Healthcare on Mission, which will be held on February 24-25 at California Baptist University and on April 14-15 at Liberty University.

Missional living in healthcare has always involved swimming upstream, but it seems to be getting harder. Our culture, workplaces and institutions are not as friendly to faith as they once were. Living on mission for Jesus and setting biblical principles as our true north can be hard. Remedy23 will challenge you to grow in your understanding of what missional living looks like. You’ll hear from missionaries, educators and thought leaders. You’ll have opportunities to explore opportunities to serve and expand your skills and knowledge. We’ll worship God together, inviting Him to shape our hearts and guide our steps.

For some, missional living will ultimately involve a plane ride to move to a far-off place for long-term service. For others, missional living happens in our own communities, institutions and workplaces here in the U.S. What does it look like for you? Join us for Remedy23 and find out! For more information and to register, visit www.cmda.org/remedy.

Upcoming Events Dates and locations are subject to change. For a full list of upcoming CMDA events, visit www.cmda.org/ events.

CMDA and DTS Dialogues: Healthcare and Theology Learning Together Webinar February 4, 2023 • Virtual Remedy23 West Mission Conference February 24-25, 2023 • Riverside, California Practice Leadership Conference February 25 - March 4, 2023 • Beaver Creek, Colorado Remedy23 East Mission Conference April 14-15, 2023 • Lynchburg, Virginia 2023 CMDA National Convention April 27-30, 2023 • Cincinnati, Ohio Area ICMDA World Congress June 20-25, 2023 • Arusha, Tanzania

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VIE Poster Session Do you know any students, residents or fellows who are looking for an opportunity to be sharpened by like-minded believers while showcasing their research project? Please encourage them to join us for the annual VIE Poster Session at the 2023 CMDA National Convention in the Cincinnati, Ohio area on April 27-30, 2023.

Any healthcare student, resident or fellow is eligible to participate.

They can share their clinical vignette, case report/series, basic-science report, clinical/transaction report or literature review. We especially are looking for presentations in areas of spirituality, ethics, education, computational biology, mathematical modeling, biophysics, biotechnology, biomedical science, medicine, surgery, dentistry, nursing, medical humanities and more.

Cash prizes are awarded for content and presentation. Plus, scholarships to attend the National Convention are also available.

The submission deadline is January 31, 2023. For more information and to submit an abstract, visit www.cmda.org/vie.

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Thank you for being a member of CMDA. Membership is the link that connects you to missions, community and advocacy.

It is a privilege to be part of your journey.

Start or Renew Your Membership Today

“CMDA reminds me to keep first things first and wake up every day and live out Christ’s powerful words, ‘Follow me.’ CMDA has been an incredible blessing in my life and I am committed to serving with and through CMDA for the rest of my life.”

—Jacob R. Morris, MD

Let us know how we can support you so that you continue to make a difference.

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CMDA Member Services 888-230-2637 www.cmda.org/join memberservices@cmda.org

Ministry News COMMUNITY

New Specialty Sections CMDA is excited to welcome two new Specialty Sections to our growing list. First is the Dental Hygiene Section, which seeks to provide community for Christian dental hygienists. The mission of this section is to engage in continuing education, provide volunteer care through CMDA endeavors and support and encourage each other spiritually and emotionally in providing care to patients.

Second is the Obstetrics and Gynecology Section, and its mission is to educate, encourage and equip Christian practitioners in obstetrics, gynecology and women’s health by demonstrating the love and compassion of the Lord Jesus Christ to patients, to families, to colleagues, to our communities and to the world.

Among all of our various ministries, CMDA’s Specialty Sections give you the unique opportunity to equip, network and fellowship with colleagues in your specific healthcare specialty. Organized by CMDA members, the sections listed below provide a wealth of resources for those who wish to connect with their colleagues.

1. Addiction Medicine Section (AMS) 2. Christian Academic Physicians and Scientists (CAPS) 3. Christian Healthcare Executive Collaborative (CHEC) 4. Christian Physical Rehab Professionals (CPRP) 5. Christian Surgeons Fellowship 6. Coalition of Christian Nurse Practitioners (CCNP) 7. Dental Hygiene Section 8. Dermatology Section 9. Family Medicine Section (FMS) 10. Fellowship of Christian Optometrists (FCO) 11. Fellowship of Christian Physician Assistants (FCPA) 12.

Fellowship of Christian Plastic & Reconstructive Surgeons (FCPRS) 13. Neurology Section 14. Obstetrics and Gynecology Section 15. Psychiatry Section 16. Ultrasound Education (UES) Don’t see a section for your specialty? New sections are currently under development with CMDA’s Campus & Community Ministries.

Contact ccm@cmda.org for more information about getting involved or starting a section.

CMDA's Center for Well-being is Expanding Did you know CMDA’s Center for Well-being has been expanding? We’ve been expanding our list of services for you, our CMDA members. Our mission is “coaching and caring for healthcare professionals.” We have been observing and listening to the needs of our members as they navigate challenging times.

Did you know we have experienced professional coaches available to help you through the opportunities and challenges you face in healthcare? Email us at coaching@cmda.org to learn more. Did you know we offer certified coaching training courses that prepare you with the skills for coaching those in your sphere of influence? Our two popular continuing education qualified coaching courses are having a tremendous impact in the healthcare community.

Did you know the Marriage Ministry falls under the Center for Well-being? We offer Marriage Enrichment Weekends and retreats for our membership to refresh and restore their marriages. Did you know the Medical Malpractice Ministry would love to help you as you walk through the difficult challenge of facing your malpractice lawsuit? We know this can be a stressful time in your life, and we have a team of doctors who have been where you are and want to help you through the challenge.

Did you know we now offer classes and resources for mentoring with a coach approach? You can gain insight into investing in the next generation of healthcare professionals. Did you know we now offer coaching and member care for our healthcare missionaries?

Did you know that in addition to the professional care you can receive, we are also investing in pastoral care for our members?

To learn more about the ministries available in the Center for Well-being, visit www.cmda.org/wellbeing.

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Ministry News MEMBER NEWS

In Memoriam Our hearts are with the family members of the following CMDA members who have passed in recent months. We thank them for their support of CMDA and their service to Christ.

• Wayne Bigelow, MD – Rocklin, California Member since 1955 • Sherif Hanna, MD – Willowdale, Ontario, Canada Member since 2021 • Lisa Ruschak, MD – Erie, Colorado Member since 2001

Memoriam and Honorarium Gifts Gifts received July through September 2022

eith and Doris Allshouse in memory of Bert Kelling K Elward Family in honor of Dr. Janet Jefferies Dr. Penny and Mr. Dale Rogers in honor of Mike and

Missy McMullan Dr. and Mrs. Marvin R. Jewell, Jr. in honor of Allan Harmer

For more information about honorarium and memoriam gifts, please contact stewardship@cmda.org.

Member Awards James A. Brown, MD

CMDA member James A. Brown, MD, received the Academic Global Surgeon Award from the American College of Surgeons in honor of his nearly two decades of work providing surgical education and training to physicians in Cameroon. In 2008, Dr. Brown and his wife moved to Cameroon to assist in addressing the lack of surgical services in the country.

His contributions to academic surgery in Cameroon, through his work at Mbingo Baptist Hospital, have been transformative. A total of 50 African surgical residents have received training from Mbingo in Dr. Brown’s tenure, and 20 surgical graduates from the Mbingo program now work in nine African countries. In the face of the ongoing Cameroonian civil war, which has brought active conflict and threats of violence against himself, his wife, staff and students, Dr. Brown’s work to train residents and treat patients has continued. Though training has often been interrupted, thousands of patients who would not have had access to care have received the care they needed.

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Ted Sugimoto, MD, FACS

CMDA member Ted Sugimoto, MD, FACS, received the Surgical Humanitarian Award from the American College of Surgeons in honor of his more than three decades of work providing surgical care to disadvantaged patients in several African countries.

In 1989, he began his full-time career in surgical volunteerism in the Zaire, now the Democratic Republic of Congo (DRC), and has since split his time between DRC, Kenya, Senegal and Somalia. Much of Dr. Sugimoto’s surgical career was spent in the DRC and Somalia, both volatile areas, and sometimes conflicts put him and his family in personal peril. Throughout dire situations, Dr. Sugimoto continued to deliver care for locals and those who suffered casualties from the conflict.

Dr. Sugimoto also has been heavily involved in training the next generation of healthcare professionals, who are often local physicians who had limited exposure to surgery during medical school. He taught at both the nursing and medical schools, training DRC postgraduate general medicine students in surgery. He has served as an instructor and principal at a nursing school; an intern instructor in Kenya; and both an academic and hands-on surgery education leader in Somalia—where the program is now largely run by locals—demonstrating the long-term impact of his work.

Celebrating Dr. Charles Smith Happy birthday to Dr. Charles Smith who recently celebrated his 100th birthday! He is an Emeritus Member of CMDA from Indianapolis, Indiana and has spent his entire life sacrificially giving to medical John Isch, MD; Charles Kelly, MD; Charles Smith, missions. It was his lifelong dream ▲ MD; Scott Pittman, MD; a family friend holding to be a medical missionary. Unfortuthe cake; and Midwest Regional Director Allan Harmer, DMin, as they surrounded Dr. Charles nately, he contracted tuberculosis in smith in celebration of his 100th birthday. residency and was denied entrance into medical missions by six different mission agencies. Although confined to a sanatorium for two years, he decided that if he was not able to go to the mission field, he would dedicate his life to helping others get there. He and his wife chose to live on 10 percent of his radiology income and invest the rest in missions, eventually supporting more than 100 missionaries. He later wrote a booklet published by InterVarsity entitled, What To Do If You Don’t Go Overseas. He eventually did travel overseas to Pakistan and later in the 1980s to Azerbaijan to visit missionaries he and his wife supported.

Charles also hosted CMDA and InterVarsity student gatherings in his home. It was not unusual for them to host as many as 300 students at one of their home meetings. He has mentored countless men over the years. Indianapolis Council member Scott Pittman, MD, described Dr. Smith as his spiritual father since his own father was not a Christian. Charles was the spiritual mentor that became his source of challenge and encouragement in medicine, marriage and spiritual life.

Join The Practice Faith-based Direct Primary Care Established in 2010 by CMDA member Dr. Jan Mensink with the vision of providing concierge medicine for the common man, The Practice in Bakersfield, California is the fourth largest direct primary care practice in America.

The direct pay model we work on is a win-win for doctors and patients; it is very financially beneficial for both sides, and because doctors have time to do quality medical care, patients get healthier and doctors have greater job satisfaction. Direct primary care also provides a wonderful work/life balance because of the longer visits, little to no insurance paperwork, smaller patient panels vs. numerous patients for typical insurance taking primary care doctor.

We are seeking a doctor for immediate employment and the unique opportunity of taking over this thriving functional medicine practice when Dr. Mensink retires in a few years.

During full-time employment now, the candidate will work closely with Dr. Mensink to be well prepared to take over as Dr. Mensink phases out. The Practice is continuing to grow at a phenomenal rate, and Dr. Mensink is seeking to reduce his hours and turn the practice over to an associate in the next two to five years.

For more information, contact CMDA Placement Services at placement@cmda.org or visit www.cmda.org/placement.

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EMBRACE RECOVERY

A Time to Embrace

RECOVERY Darren Caparaso, MD

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EVER SINCE I INCLUDED GOD INTO MY RECOVERY, I’VE ACTUALLY FOUND RECOVERY. STUDYING HIS WORD AND IMPLEMENTING IT INTO MY LIFE GIVES ME LIFE. JESUS REALLY DOES SAVE!

A

—ROBIN

s those called to the healing profession, we have all lived and practiced through old and unprecedented new challenges in our careers. We can all agree the last few years have surely been unlike any we have ever experienced before in our lives. Frontline healthcare workers felt the brunt of a pandemic on a daily basis, while also enduring the devastating impact of yet another challenge of a public health crisis that continues to escalate.

That crisis is addiction.

For the first time in our nation’s history, fentanyl overdoses/ poisonings have surged to become the number one cause of death for ages 18 to 45, according to the U.S. Centers for Disease Control and Prevention. It’s a shocking and alarming statistic. Our nation experienced approximately 107,600 overdose deaths in 2021 alone—soaring to become the highest ever recorded.

As a family medicine physician for nearly 30 years, it is an honor and privilege to be involved in patients’ lives, as the patients I treat become family to me. It is a true joy celebrating all the milestones in the lives of these patients, including newborn babies, weddings, athletic awards, academic accomplishments and vocational achievements. Of course, the journey also includes entering the sufferings of people and family members during the darkest times of those experiencing addiction and its terrible aftermath of broken bodies, broken souls, broken spirits, broken relationships and even the shock of sudden death. As the Bible says in Romans 12:15, I strive to “Rejoice with those who rejoice; mourn with those who mourn.”

My patients, my community and my church feel the pain and heartbreak of the growing addiction health crisis. More than likely, you see the same pain and heartbreak in your practice and in your city. However, despite the suffering, we have HOPE!

I am grateful to have grown up and continue to live in Buffalo, New York, which is known as the “City of Good Neighbors.”

In Luke 10, Jesus was asked, “And who is my neighbor?” (Luke 10:29b). Our Lord answered by sharing the well-known story of the Good Samaritan. I believe with all my heart that God loves my hometown of Buffalo, as He does every city in our nation. He has great plans for healing our land (2 Chronicles 7:14).

As Buffalonians, from generation to generation, we have consistently demonstrated that we truly care about each other and are willing to generously help struggling, hurting people turn their lives around. The Lord is calling all of us to be Good Samaritans as Jesus taught, and I believe the church is the safe inn for hurting people to heal. We believe the abundant life spoken of in John 10:10 is living in communion with God and community with each other. For all of our sons and daughters who are

GET INVOLVED The Addiction Medicine Section of CMDA exists to prevent and treat addiction and transform lives, by God’s grace, love and power. We strive to provide compassionate excellence in all aspects of addiction care, including whole-person prevention and treatment, education, advocacy, empowerment of others, research, church, and community partnerships, and interprofessional collaboration and support. For more information and to get involved, visit www.cmda.org/ams.

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MY JOURNEY HAS BEEN A VERY LONG ONE, INCLUDING NOT A DENIAL THAT THERE IS A LORD BUT MORE OF A ‘I DON’T NEED HIM.’ AT THE DARKEST TIME

far from home, the parable of the prodigal son inspires us to never give up hope. Luke 15:20 shares the story of a son who was still a long way off when his father saw him coming.

Filled with love and compassion, the father ran to his son and EMBRACED him.

IN MY LIFE, THE HOLY SPIRIT EMBRACE RECOVERY BUFFALO VISITED WITH AN INCREDIBLY STRONG MESSAGE OF HOPE. SINCE THEN, I HAVE SEARCHED AND FOUND HELP WITH PHYSICIANS WHO HAVE ENCOURAGED ME AND PROVIDED ASSISTANCE WITH PHARMACEUTICAL INTERVENTIONS. THE ROAD WAS STILL QUITE BUMPY, BUT EVENTUALLY

Embrace Recovery Buffalo was birthed in 2016 out of a desperate heart cry and a mission to help those struggling with addiction or life-controlling problems find compassion, hope, healing and lifelong recovery through a collaborative effort that includes a biblical faith-based approach. Just like the father embraced his lost son, we seek to embrace those who are lost and searching through the fog of addiction.

WITH FAITH, HOPE AND A LOT OF

Western New York is home to the nationally recognized LOVE I FOUND A WAY FORWARD. Erie County Opiate Epidemic THERE IS A TREMENDOUS NET- Task Force, whose efforts are making significant strides with WORK OF BELIEVERS OUT THERE a collaborative approach that WHO CAN GIVE YOU HOPE AND A is producing results. The task force has strong relationships WAY TO GRACE IF YOU’RE OPEN with law enforcement and the nation’s first opioid intervenTO IT. PASS IT ON. —DOUG tion court. In addition, the University at Buffalo (UB) is fighting addiction through research education and clinical care. UB has more than 150 faculty and scientists (including fellow CMDA members) investigating addiction, and they are educating students in all of the health science disciplines (medicine, nursing, social work, pharmacy, dentistry and public health).

UB’s Clinical and Research Institute on Addictions (CRIA) is a long-standing leader in the study of alcohol and substance use disorder. Dr. Richard Blondell, who is a national leader in addiction medicine, developed an addiction medicine fellowship in UB’s Department of Family Medicine in 2011. It is one of the nation’s first post graduate addition medicine fellowships.

For many years, UB’s Faith and Medicine elective has provided medical students opportunities to see how a life filled with faith can powerfully impact the lives of our patients. The elective allows medical students to visit many Embrace Recovery Buffalo 14 | CMDA TODAY | WINTER 2022

Community Connections and hear powerful testimonies that will be remembered for a lifetime.

Our Community Connections include: Adult and Teen Challenge, founded by Pastor David Wilkerson with more than 220 residential program locations across North America; Total Freedom Darien, which has a faith-based residential rural campus; Kids Escaping Drugs, that helps to educate in addition to treatment; and Buffalo City Mission. Healthcare students also have academic opportunities at large organizations that have been dedicated to addiction and mental healthcare in Western New York for decades.

Caring for those suffering with addiction and commonly cooccurring mental health conditions, such as anxiety and depression, is a vitally important local mission to our community and our team. Having mercy on those with conditions of despair, we become the hands and feet of Jesus in our city as we seek to rescue, recover and restore.

Our team continues to educate, equip and engage healthcare professionals, patients and families in our community to shed light on the stigma and ignorance that shroud addiction. Addiction care is just as important as any other type of healthcare.

Similar to other chronic health conditions such as diabetes, heart disease and cancer, substance and alcohol use disorder can be successfully screened, diagnosed and effectively treated in primary care, hospital, emergency room, behavioral health and other clinical settings. We train healthcare professionals to use tools such as Screening Brief Intervention and Referral to Treatment (SBIRT) and motivational interviewing.

HUB AND SPOKE—THE IMPORTANCE OF PARTNERSHIPS

I believe the key to success in making a difference in our community’s struggle with opioids is found in building and

strengthening relationships and partnerships. That includes implementing both clinical and community care teams in a growing regional “hub and spoke” model of care that was launched from a UB Addiction Medicine Fellowship Project. Treatment plans of care include evidence-based effective medications, mental health counseling, recovery coaching and thriving community support groups.

In Buffalo, we have trained several dozen life recovery coaches in churches, ministries and organizations that are an integral part of the community care team that leads people on their path to recovery in a variety of clinical and community settings. Recovery coaches guide and support people to achieve and maintain the goals of recovery. Our vision is to educate, equip and engage coaches in every church, and in each neigh▲ Dr. Darren Caparaso (far right) with other life recovery coaches and patient. borhood, to create a safety net, understanding God’s heart that none shall perish. It says in 2 Peter 3:9, “The Lord is not slow about His promise, as some count The Bible story found in the gospels of Matthew, Mark and slowness, but is patient toward you, not willing for any to perish, Luke describe the four faithful friends carrying a paralytic. That but for all to come to repentance” (NASB). gospel story also tells our Embrace Recovery Buffalo story.

To help accomplish that vision, we provide free recovery Bibles, journals, biblical resources and educational tools to equip healthcare professionals, students, organizations, ministries, patients and families.

A TIME TO EMBRACE

The addiction crisis continues to claim tens of thousands of lives each year. Sadly, current evidence suggests worsening of disparities in access to care and mortality of the underserved. The need to identify and treat has never been more urgent. Out of 10 people who suffer from substance use disorder or alcohol use disorder, only one or two receive appropriate care. Only one or two…out of 10. It’s a disheartening and eye-opening statistic.

Hurting people deserve the same compassionate care we all expect from our healthcare professionals, and that means we need to work together to treat people with love, dignity and respect.

Addiction medicine is our opportunity to collaborate together as we teach “medicine to ministry” and “ministry to medicine.”

WHEN I ENVISIONED MY ROLE AS A RECOVERY COACH, I SEE TWO PEOPLE WALKING SHOULDER TO SHOULDER, ONE, THE RECOVEREE, WORKING THE SELF-SELECTED PROCESS TOWARD RECOVERY. THE COACH, SUPPORTING BY PROMOTING RECOVERY WITH COMMUNITY SUPPORT SERVICES AS USEFUL, ENCOURAGING HOPE, POSITIVITY, HEALTH AND A PERSONAL RELATIONSHIP WITH GOD. —JEAN

The four faithful friends were purpose driven, dedicated and intentional, and they demonstrated perseverance with sacrificial love by punching a hole in the roof to bring a lame hurting friend to Jesus, the Great Physician. Our Lord Jesus embraced the hurting and broken. The faithfulness of the four friends resulted in the awesome healing of spirit, soul and body! As it says in Psalm 133:1, “How good and pleasant it is when God’s people live together in unity!”

Each friend did their part to complete the mission. Ephesians 4:12 says, “to equip his people for works of service, so that the body of Christ may be built up.”

At Embrace Recovery Buffalo, our prayer is that we may all have the courage and strength to do the same. Which friend are you?

Are you the educator, healthcare professional, student, law enforcer, recovery coach, loved one, counselor, neighbor, teacher, researcher, athlete, etc.? The Lord is equipping you with the tools, the networks and the connections you need to follow His will and to allow Him to work through you. Are you ready to embrace recovery?

Darren Caparaso, MD, is a family medicine and addiction medicine physician. He is the Founder and Co-director of Embrace Recovery Buffalo, a ministry affiliated with CMDA with the mission to help those struggling with addiction or life-controlling problems find compassion, hope, healing and lifelong recovery through a collaborative effort that includes a biblical faith-based approach. He serves as the Addiction Medicine Section Outreach Coordinator. For more information about Embrace Recovery Buffalo, visit www.cmdawny. org/embrace-recovery-about. www.cmda.org | 15

BUILDING A FOUNDATION TO

N

RECOVERY David Holmes, MD

umerous medical research studies support the idea that health and well-being are affected by four main aspects of a person’s life: physical, psychological, social and spiritual. These aspects also affect recovery from addictions to drugs, alcohol, tobacco, sex, gambling, etc. This is called the bio-psycho-social-spiritual model of whole-person healthcare.

I use this model when taking a patient’s history and recommending a treatment plan. So much of healthcare is focused on the biological or physical aspects of health. We need to learn and strive to provide excellent physical medical care. However, I think all healthcare professionals should also strive to provide excellent psycho-social-spiritual medical care.

When asking psycho-social-spiritual questions, I often ask patients about their biggest stressors and how they cope with them.

Probably half of the inpatients I see on a general medical floor in a local hospital are there because of unhealthy ways of coping with stress, anxiety, sadness, boredom or loneliness. These unhealthy coping strategies, such as smoking, overeating, alcohol, inactivity, anger, drugs, isolation, inactivity, etc., can contribute to problems including ulcers, cirrhosis, heart disease, seizures, injuries, anxiety, some types of cancer, etc. This doesn’t mean these problems are always, or even usually, caused by unhealthy coping strategies, as other factors contribute to these conditions. However, for a number of people, unhealthy coping strategies likely contribute to their health problems.

Once I identify a patient has unhealthy coping strategies, I work with them to identify healthy coping strategies they could use instead. Some of these strategies include exercising, praying, listening to peaceful music, going for a walk, reading Scripture, journaling, doing a hobby they enjoy and talking with someone they trust, like a friend, family member, pastor or counselor. I also use the bio-psycho-social-spiritual model when I’m working with the patient to formulate a treatment plan. We focus on items they think they can start doing, and then I document the action points in the electronic health record so I can remember to follow up with them at future visits.

A number of years ago, I heard Dr. John Patrick talk about the four levels of happiness on CMDA’s Christian Doctor’s Digest (now called CMDA Matters). Ever since, I’ve included that material in required seminars I teach to medical students about whole-person healthcare. I also use this material in talking with patients who are struggling with addictions.

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▲ University of Buffalo doctors and students visit Save The Michaels of The World.

1. Animal Happiness (short-term, self-focused) You may be unhappy or grumpy because you’re hungry. Then you eat a big meal and you’re happy. A few hours later, you can repeat the whole process again. The same is true if you’re tired and then get some sleep. Other examples of short-term happiness include sex, shelter, health, things, money, pornography, smoking, drugs, alcohol, shopping, etc. Some of these things do bring happiness, but it’s on a short-term basis.

Some things can lead to unhappiness. For instance, too much eating can lead to obesity. Smoking and excessive alcohol use can lead to addictions and health problems.

2. Accomplishments (self-focused) Accomplishments provide a deeper sense of happiness and satisfaction. Some examples include doing well on an exam, receiving an award, accomplishing chores at home, getting a good job, reaching a goal, winning a competition, etc. These provide a little deeper sense of happiness and satisfaction in life. However, there are lots of people with great jobs who are still miserable. Therefore, we need more than just our accomplishments to be happy and content.

3. Relationships and Service (others-focused) Unlike the previous two levels, this level focuses on others. Some examples include relationships with your spouse, children, relatives, friends, co-workers, patients and others. It’s also about serving others, such as volunteering and giving of your

time, talents and treasure. We all have a need to be needed, so helping others also helps ourselves. However, relationships sometimes don’t work out well. Sometimes, marriages end in divorce. Children grow up and leave the home.

Some children rebel. There may be conflicts and tension with friends. Loved ones may die. Then what do we do?

We need to rely on our foundation.

4. Foundation (God-focused or beliefs-focused) Examples of a foundation are faith, beliefs, values, culture, identity and integrity.

The first three levels of happiness can all be taken away from you. Your foundation is the part of you that can never be taken away. It gives you meaning and purpose in life and can help you through the storms and challenges of life.

The purpose of the foundation of a building is to help it stay standing when storms and bad weather hit. Without a strong foundation, the building may crack and collapse. The same is true with our lives. If we have a weak foundation, then, when the storms and problems hit, we will struggle with those things, because they are difficult. However, if we have a strong foundation, we’ll be able to stay standing and move forward with our lives. If we don’t have a strong foundation, then when the storms arrive, we’re going to collapse. There will be problem on top of problem, and it will be difficult to dig our way out. When I get to this point with patients, they often relate to having a collapsed life with problems piling on top of one another. At this point, even patients who don’t profess much in terms of spiritual beliefs begin to understand the importance of having a strong foundation. This can open the door to a conversation about how faith can help in building a strong foundation.

If I sense a patient might be interested, I’ll offer them a Life Recovery Bible, which is donated by Embrace Recovery Buffalo.

This Bible is filled with explanations about how certain passages in the Bible relate to the 12 steps of Alcoholics Anonymous or Narcotics Anonymous. I suggest they read a few verses each day. Just as having physical food each day helps nourish our bodies, having spiritual and inspirational food each day helps nourish our souls and strengthen our foundation. Some patients like to journal or are open to doing it. I often offer these patients the Recovery Journal, which is also provided free of charge by Embrace Recovery. Each day has a Scripture verse and brief devotional, followed by space for them to journal a response.

If I don’t sense they would be interested in either the Bible or the journal, I offer The Daily Bread devotional booklet, which is available in bulk at no cost from odb.org/getprint. I try to offer it in a non-pushing way, so they don’t feel obligated to take one.

In terms of praying with patients, here are the general guidelines I use: 1.

I usually only ask patients if they would like prayer if I’m almost certain they will say yes. Taking a spiritual history usually helps me to know if a patient will appreciate prayer or not.

2. Some people believe it is best to only pray with a patient if the patient initiates a request for it. That may be the best

indication for praying with a patient, but the problem is that it is not common for healthcare professionals to pray with patients. Therefore, most patients wouldn’t even think to ask you to pray for them, especially if they don’t know if you do that with patients. Therefore, it’s up to Christian healthcare professionals to somehow communicate this to their patients. I choose to do that by asking, in a nonjudgmental way, if they would like me to pray for them.

3.

If the patient says they would like prayer, then I ask them what prayer requests they have. This helps me to know what to focus my prayer on, and it also gives me a glimpse into what’s going on in their heart.

4. In general, my prayers are brief and focused on the patient’s prayer requests. I also include gratitude for something positive going on in the patient’s life and/or aspects of God’s character, such as His love and help that He freely gives us.

Finally, I often include parts of the treatment plan, such as for God to help them quit smoking.

5. I document prayers in the medical record; that way, when I see the patient again, I can be reminded of the fact that we prayed and what we prayed for. If I don’t document this and I don’t remember, then when I see the patient and don’t ask about how things are going with whatever we prayed for, it may appear that I am uncaring about what the patient was struggling with during the previous visit.

I work in a county hospital and clinic, plus I’m on faculty at a state medical school. In 27 years of medical practice and addressing spiritual issues with patients, I’ve had countless positive and meaningful moments with patients, as addressing these issues often strengthens trust and rapport. In that time, I’ve only received a couple complaints from administrators about my faith-based approach to patient care. I simply explain the truth—that I’m practicing evidence-based, patient-centered, whole-person healthcare.

There’s not much they can say in response to that. At the end of my conversation with one of the administrators, she asked if she could have one of the Life Recovery Bibles that I give to patients and if I’d be willing to teach the clinic staff about spirituality in health. Of course, I said yes to both. It’s amazing how God can use all sorts of things to share the truth of His Word and the valuable role faith plays in our health and well-being, especially when it comes to creating a strong foundation in recovery from addiction.

David Holmes, MD, is a Clinical Associate Professor in the Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, SUNY at Buffalo (UB). He is board certified in family medicine and addiction medicine. He directs the Global Medicine Program and the spirituality in medicine curriculum for the medical school.

He’s an Associate Program Director for the family medicine residency program. His research interests focus on global health and the role of faith in addiction recovery. He says that his personal mission statement is “to love and honor God and my family and make a positive and significant difference in the lives of others.”

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Healing from the Violence of Busyness

Five Biblical and Theological Reflections on Time and Work Emmy Yang, MD, MTS

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A

s a medical student, I learned that efficiency was a critical skill in medicine. Each morning, I carefully charted my course through the hospital to pre-round on each of my patients. When a medical code alert went off, my team took the stairs and not the elevators to save us precious seconds in the resuscitation. A “good” intern, I learned, gets their notes done as soon as possible.

This diligent use of time was often necessitated. It meant all 16 patients with appointments could be seen in clinic that day.

It meant a trauma patient could be rapidly assessed in the emergency room and taken to the operating room if needed.

However, I started to notice how this mindset of efficiency extended into life outside of medical school. My personal life became a checklist. My days were defined by how many practice questions I reviewed, meals I prepped and emails I sent and answered. I struggled to see where relationships fit in this paradigm of “efficiency.”

Pastor and theologian Simon Carey Holt writes, “Prolonged busyness is a state of violence…to the human soul, the community, and earth.”1 This violence manifests in medicine in high rates of burnout, moral injury, healthcare worker attrition and poor patient outcomes.2,3 Against a cultural background of optimization, described by Anne Helen Petersen as the “dominant millennial condition,”4 time is lost for therapeutic alliances: between clinicians and patients and clinicians and their communities. Time and human labor become commodities for optimization.

Yet, the first mention of humans in Genesis is not what humans do, but who humans are. Genesis 1:26 says, “Let us make man in our image, after our likeness…” (ESV). Humanity’s primary identity resides in the imago dei. God defines our very being, breathing life into our bodies (Genesis 2:7). We are first human beings, not human doings.6 For Christian healthcare professionals, our works are never definitive of our core identity as beloved image-bearers of God. We hold fast to the truth that God loves us the same, whether or not we are efficient. And inevitably, when we fail to be patient, stay on schedule or make it in time for dinner, we are still holy image-bearers.

2. T ime is given as a gift for loving God and neighbor.

In order to know how we are to faithfully embody time, first we must know what time is for.

Jesus explains time’s purpose clearly when He said the greatest commandments are to “love the Lord your God with all your heart…soul and…mind” and to “love your neighbor as yourself ” (Matthew 22:36-40, ESV). The purpose of time is to love God and neighbor. Theologian and mental health practitioner John Swinton describes time as a “gift from a loving Creator.”7 As a gift, our finite time on earth is an opportunity to share in the life of Christ. Rather than days measured by relative-value units and progress notes completed, Jesus’ life was marked by service toward others. In Mark 5, while on the way to the home of a man with a dying daughter, Jesus stopped in the middle of

For Christians, these insults invite reflections on what Scripture and theological tradition teach us about time— specifically, our relationship to time and its Creator. As a student of the Theology, Medicine, and Culture fellowship at Duke Divinity School5 and a physicianin-training, I was consumed by these questions and desired to learn how we heal from the “violence” of busyness.

For those weary and burdened, I offer these five biblical and theological reflections.

1. We are first human beings, not human doings.

In Genesis 2:15, God tasks Adam and Eve with cultivating the good gifts of creation.

The first humans were responsible for the land. Work is an essential part of our vocation as humans. Work is good. www.cmda.org | 19

LEARN MORE Healthcare professionals pour themselves out for others every day, and CMDA’s Center for Well-being is the place to be refilled! If you find yourself feeling burned out or in distress, then the Center for Well-being is for you. We want to help you align with God, optimize your well-being and maximize your influence. We want to help you find the “sweet spot” of life again, to help you find or regain what the Bible calls “Shalom.” For more information, visit www.cmda.org/wellbeing.

a great crowd after encountering a woman who had bled continuously for 12 years. He spoke a word of affirmation over her: “Daughter, your faith has made you well; go in peace, and be healed of your disease” (Mark 5:34b, ESV).

At its foundation, the work of healthcare commits to restoring health and attending to the ill and suffering. This is our primary vocation in healthcare and how we are called to spend our time. And yet, so often, loving God and others well—let alone, loving ourselves—is what countless practitioners find difficult to do in modern healthcare.

3. The account of man’s fall helps us understand the violent rhythms of human time and identify areas needing change.

Genesis 3 imparts the story of man’s fall and inheritance of original sin by humanity. This narrative contextualizes humanity’s fallen relationship to time. Contrary to the ends of loving God and neighbor, time is utilized as an instrument of profit— hence, the maxim that “time is money.” However, Jesus is clear that we cannot serve God and money (Matthew 6:24).

This relationship is a corruption of the way God designed human life to be. Allied healthcare professionals are treated as commodities of labor.8 Resource-intensive patients are shunted away from insurance plans and hospitals. These occurrences are evidence of the structural and systemic sin pervading our healthcare systems.

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For Christians in healthcare, this understanding of sin has two consequences. The first is prompting a posture of gentleness and compassion toward ourselves. When healthcare professionals are left hurried and unable to fully attend to their patients, it is not for lack of virtue. Powers and principalities render absence and distance to patient suffering far more tenable than presence.9 Such knowledge demands we have compassion when we fall short of our ideals.

The second consequence of our theology of sin helps us identify work schedules and care structures counter to the loving mission of healthcare as spaces for reform. Our faith calls us to actively participate in the weeding out of greed and exploitation. When Jesus encountered tradesmen making the temple courts into a place of commerce, He flipped their tables over, chastising them for turning a profit from a sacred space (Matthew 21:12-13). The sacred work of healthcare must be protected from institutional incentives focused exclusively on efficiency and the bottom line.

4. Jesus is present in every moment—in the rush and in the busyness—and is calling us to discern when to slow down.

God does not always call us to slowness; instead, He calls us to discern moments that require our slowing down. The Gospels describe Jesus as someone who lingered to heal the sick and break bread with tax collectors and sinners (Matthew 9:10). Yet, Jesus also moved impassionedly. Luke described Jesus setting out “res-

olutely” for Jerusalem as His crucifixion drew near (Luke 9:5152). To love others with our time in healthcare often means using our time efficiently. As bioethicist and internist Lydia Dugdale stated, “Since God is outside of time, I am convinced he can run with me when I am running (how else did I make it through residency training with a faith more robust than when I started?).”10

Furthermore, because God comes into human time in the person of Christ, Christians need not “escape time.”12 We know where the story is going. Our lives have been shaped by the dispensation of God’s love. As theologian and ethicist Stanley Hauerwas wrote, we have been given the time we need “reconciled to one another and thus to God.”13

The practice of prayer centers us toward God throughout the busy workday. In prayer, we seek God’s direction in how we are to use our time and who we are called to love at any given moment. In prayer, we find restoration and safety in moments of cognitive overload and emotional exhaustion. This practice cannot be commodified or billed for as a service rendered in patient care. However, it is a practice that aligns us closer and closer to the way God designed us to use our time.

Christians are invited to live into this redeemed time in the here and now. Every Sunday, we worship in communities that remember this storied time. The rhythm of gathering upsets a linear notion of time co-opted for production. The practitioner sets aside her inbox, as it steadily accumulates new mail, prescription refill requests and lab notifications. At the foot of the cross, she lays her weariness and burdens.

Whether we move at a fast or slow pace, we are equidistant to the saving grace of the cross. The 14th century mystic Julian of Norwich reflects that God is at the “mid-point of everything.”11 At the core of our temporal existence is the love and mercy of an omnipresent God.

5. We live in storied time with a trajectory toward the redemption of humanity.

Scripture teaches that the arc of humanity is redemption of its fallenness. Death, illness and prior authorizations will be no more. Time will cease to be burdensome.

The trainee or practitioner whose shifts extend to Sundays still participates in this storied time. At work, when she remembers that her real work is not documentation but to love her patients...when she remembers to be merciful to herself when she is slow at suturing or quick with a patient…when she uses her positions of power to advocate for more compassionate work schedules and wages, she lives into God’s time.

Endnotes 1 Simon Carey Holt, “Slow Time in a Fast World: A Spirituality of Rest,” Ministry, Society and Theology 16, no. 2 (2002), https://simoncareyholt. wordpress.com/writing/.

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2 C. P. West, L. N. Dyrbye, and T. D. Shanafelt, “Physician burnout: contributors, consequences and solutions,” J Intern Med 283, no. 6 (Jun 2018), https://doi.org/10.1111/joim.12752, https://www. ncbi.nlm.nih.gov/pubmed/29505159; E. S. Williams, C. Rathert, and S. C. Buttigieg, “The Personal and Professional Consequences of Physician Burnout: A Systematic Review of the Literature,” Review, Medical Care Research and Review 77, no. 5 (Oct 2020), https://doi. org/10.1177/1077558719856787. W. Dean, S. G. Talbot, and A. Caplan, “Clarifying the Language of Clinician Distress,” Jama 323, no. 10 (Mar 10 2020), https://doi.org/10.1001/jama.2019.21576.

3 T. D. Shanafelt et al., “Burnout and medical errors among American surgeons,” Ann Surg 251, no. 6 (Jun 2010), https://doi. org/10.1097/SLA.0b013e3181bfdab3, https://www.ncbi.nlm.nih.gov/ pubmed/19934755.

4 Anne Helen Petersen, “How Millenials Became the Burnout Generation,” BuzzFeed News, January 5, 2019 2019, https://www.buzzfeednews. com/article/annehelenpetersen/millennials-burnout-generation-debtwork?utm_source=dynamic&utm_campaign=bfsharecopy.

5 https://tmc.divinity.duke.edu/ 6 Dr. David Kim, physician and CEO of Beacon Community Health Center in Staten Island, NY and CMDA member, wrote in an email to New York chapters of CMDA that we are first “human being[s],” and not “human doing[s].”

I am grateful to Dr. Kim for this reminder and hope to keep this nugget of wisdom with me throughout my training.

7 John Swinton, Becoming Friends of Time : Disability, Timefullness, and Gentle Discipleship (Waco, TX: Baylor University Press, 2016), 58.

8 Danielle Ofri, “The Business of Health Care Depends on Exploiting Doctors and Nurses,” Opinion, New York Times (New York, NY), June 8, 2019 2019, https://www.nytimes.com/2019/06/08/opinion/sunday/

hospitals-doctors-nurses-burnouthtml?fbclid=IwAR3lXG06HlIgsVU oyVJCQ1FllF424Rf1cD3ffDWEOch2otid5rDxTjOtyYs. 9 B. W. Frush, “Suffering Absence: Hauerwas and the Challenges to Faithful Presence in Contemporary Medical Training,” Linacre Q 87, no. 4 (Nov 2020), https://doi.org/10.1177/0024363920937626, https:// www.ncbi.nlm.nih.gov/pubmed/33100394.

10 Swinton, Becoming Friends of Time : Disability, Timefullness, and Gentle Discipleship, 81.

11 Julian and B. A. Windeatt, Revelations of Divine Love, Oxford World’s Classics, (Oxford: Oxford University Press, 2015), 56.

12 Stanley Hauerwas, The Work of Theology (Grand Rapids, MI: Eerdmans, 2015), 95.

13 Hauerwas, The Work of Theology, 102.

Emmy Yang, MD, MTS, is an internal medicine resident physician at the University of North Carolina-Chapel Hill and a graduate of the Theology, Medicine, and Culture Fellowship at Duke Divinity School. While a medical student at the Icahn School of Medicine at Mount Sinai, she participated in the student chapter of CMDA. She hopes to care for her colleagues as she cares for her patients.

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Your Body Will Be Whole Meditations on Heaven Kathryn Butler, MD

D

uring my surgical training, I helped care for an aging professor who bemoaned his declining health. His mind still moved in academic circles, pondering the high points of chemistry and physics, but arthritis had so fused the bones in his neck that he couldn’t nestle into a pillow anymore.

Cancer riddled his chest, and squandered nutrients, until his frame wasted to skeletal proportions. The simple routine of enjoying a meal pitched him into coughing, and pneumonia festered from the secretions that pooled in his lungs.

One day, after one of numerous bronchoscopies to clear his airways and ward off a ventilator, he motioned to me and mumbled something. I drew closer, listening for his raspy voice above the hiss of the oxygen mask.

“Don’t get old,” he said.

Wages of Sin

While our medical conditions and paths in life vary, all of us—whether we don white coats or not—will join this professor in his grief if our Lord tarries and our earthly bodies fail. Healthcare professionals know firsthand that our vitality has a time limit, and that when we neglect the truth that the body is a temple for the Holy Spirit, we prime ourselves for disease (1 Corinthians 6:19-20). The cigarettes we smoke blacken our lungs; our overindulgences at the dinner table coat our arteries in cholesterol; and our extra glasses of alcohol inflame and destroy the liver.

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Even when we aim to steward our bodies well, our health eventually fails, because “the wages of sin is death” (Romans 6:23a). The consequences of sin penetrate even to our vessels and bones, unraveling the physiological systems that God has meticulously interwoven. As we age, our immune system deteriorates, and we succumb to infections. Calcium hardens our arteries, driving our blood pressure dangerously high.

Our bones thin, our spine weakens and we stoop toward the dust from which we came. Even our face reveals the march of time, as the production of elastin in our skin dwindles and creases deepen around our eyes.

This inching toward death, with our bodies slowly falling apart as the years march by, awaits us all. As Paul reminds us, “…sin came into the world through one man, and death through sin, and so death spread to all men because all sinned” (Romans 5:12, ESV).

The brokenness that afflicts the world also afflicts our earthly bodies, ushering us from the bloom of youth into pain, fragility and, ultimately, the grave. For many of us, humiliation and pain, frustration and grief accompany us on our decline.

Redemption of the Body Yet we have hope.

As we toil in the shadow of the cross, combating diagnoses and wrangling with ever-mounting aches and pains that both we and our patients bear, we cling to the promise that when Christ returns, “He will wipe away every tear from [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away” (Revelation 21:4, ESV). We confess our belief in the “resurrection of the body” through the Apostles’ Creed, because the New Testament teaches that the transformation already begun in us through the Holy Spirit will come to completion in the new heavens and the new earth.

“We know that the whole creation has been groaning together in the pains of childbirth until now,” Paul writes. “And not only the creation, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for adoption as sons, the redemption of our bodies” (Romans 8:22-23, ESV). In saving us from all our sins, Christ has also saved us from their wages, including the heavy toll upon our bodies.

Christianity, then, doesn’t promise that our souls will float in heaven, wrenched from their corporeal vessels. Instead, when we pine for Christ’s return, we anticipate a complete renewal: a softening of the heart, a sanctification of the mind and even a renewal of the bodies that in their present form so easily wither and break. And all so we might know God and enjoy Him forever, for His glory.

Spiritual Body

While we minster to those suffering the aches and groans of this mortal coil, it’s hard to envision a body unsullied by sin.

“What will it look like?” we may wonder. “How will it be different?”

When the church at Corinth raised such questions, they drove Paul to exasperation. Corinth was a metropolis steeped in pagan influences, including a Greek philosophy that viewed the body as debased and corrupt, and the spirit as sublime. This thinking proved a stumbling block to some early Christians in Corinth, who struggled to accept the truth of the resurrection.

How, they wondered, could the Son of God rise in the flesh, when the body was material and depraved?

Paul balked at such questions, and he highlighted that the Corinthians’ thinking reflected the limitations of human experience rather than the wisdom of God:

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“But someone will ask, ‘How are the dead raised? With what kind of body do they come?’ You foolish person! What you sow does not come to life unless it dies. And what you sow is not the body that is to be, but a bare kernel, perhaps of wheat or of some other grain. But God gives it a body as he has chosen, and to each kind of seed its own body…So is it with the resurrection of the dead. What is sown is perishable; what is raised is imperishable. It is sown in dishonor; it is raised in glory. It is sown in weakness; it is raised in power. It is sown a natural body; it is raised a spiritual body…” (1 Corinthians 15:35-28, 42-44, ESV).

In this rebuttal, Paul argues that our resurrected, spiritual body will be something totally new, dramatically different from the body we leave in the grave. Just as a plant bursts forth from its seed, so also the resurrection body will arise from the earthly body that is sown, but a radical change will occur. Through the resurrection, the body will transform from something that is perishable, dishonorable and weak—like a dormant seed—to something wholly new: imperishable, glorious and powerful.

In short, the resurrection will transform us into the image of Christ.

Bodies Made New

This promise offers a balm for the weary soul. As our earthly bodies bend and break, as our strength wanes and our groans lengthen, we cling to the hope that a day is coming when all the aches will fade away. Jesus has saved us from wrath, both body and soul. He has triumphed even over death (1 Corinthians 15:55). And through the Father’s great mercy, we share in His victory.

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Our sufferings within these mortal coils may drive us to our knees. But when Christ returns, and we kneel before His throne,

by His grace we will “[put] on the imperishable” (1 Corinthians 15:54, ESV) raise rejuvenated voices and praise Him with bodies made new.

Editor’s Note: An earlier version of this article first appeared at DesiringGod.org.

REGISTER NOW You can hear more from Dr. Butler during a plenary session at the 2023 CMDA National Convention on April 27-30, 2023 in the Cincinnati, Ohio area. This is the place to find resilience in life, in faith and in practice. Our speakers include former U.S. Surgeon General Jerome Adams, Dr. Darrell Bock from Dallas Theological Seminary, Dr. Kathryn Butler and many more. For more information and to register, visit natcon.cmda.org.

Kathryn Butler, MD, received her medical degree from Columbia University and trained in general surgery and surgical critical care at Massachusetts General Hospital and Harvard Medical School, where she then joined the faculty. She left clinical practice in 2016 to homeschool her children, and now she writes regularly for DesiringGod.org and The Gospel Coalition on topics at the intersection of faith and medicine. She is the author of Between Life and Death: A Gospel-Centered Guide to End-of-Life Medical Care and Glimmers of Grace: A Doctor’s Reflections on Faith, Suffering, and the Goodness of God.

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Doug Lindberg, MD

“It was the best of times, it was the worst of times…

It was the season of Light, it was the season of Darkness.

It was the spring of hope, it was the winter of despair….”

—Charles Dickens, A Tale of Two Cities

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s the trappings of the Thanksgiving and Christmas seasons emerge around us in North America, things look and feel quite different for our colleagues serving around the world. For crosscultural missionaries serving far from home, this time of year is complicated.

Charles Dickens’ famous lead-in from A Tale of Two Cities nails it. It’s both beautiful and brutal. It’s filled with both fellowship and loneliness. It’s light, and it’s dark. You love being there, and yet you wish you could be home, all at the same time.

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On the one hand, it is truly a joy to learn about the culture and traditions of the host culture. New Christmas carols in a new language. New foods and smells coming from kitchens and church courtyards. New ways to approach gift giving. Seeing how another culture marks the birth of our Savior can reveal new facets of the wonder that is Christ taking on flesh. And there are even new holidays to celebrate! These are fun and special moments and events to experience.

It’s also an opportunity to share some special parts of American holiday culture with friends and colleagues.

GET INVOLVED CMDA’s Center for Advancing Healthcare Missions (CAHM) seeks to mobilize and support physicians, dentists, nurses, therapists and other health personnel to use their professional skills to help people encounter Jesus, here in the U.S. and around the world. For more information and to get involved, visit www.cmda.org/cahm.

Thanksgiving is not a holiday most of the world observes, so gathering national and missionary friends together to give thanks and feast together is wonderful. Somehow this particular holiday seems to transcend culture. Giving thanks and sharing a meal is good for our souls, regardless of our nationality.

However, for countless missionaries, the holiday season can also be a grind. Healthcare missionaries face the same challenges our healthcare colleagues back home do of needing to continue to provide clinical coverage. It doesn’t matter

if you’re in Detroit or in Dakar, it’s no fun to have to work overnight in the emergency room on Thanksgiving or go in for a C-section in the middle of Christmas dinner.

Additionally, being far from family and the traditions of holidays at home is hard. Missing out on holding a newborn niece or nephew, watching NFL games, hugging people you love and eating mom’s special green bean casserole and pumpkin pie— these are all little, but necessary, sacrifices. And if a missionary has experienced the loss of a loved one recently, being away from family can be especially difficult.

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Nevertheless, along with the sacrifices come new joys. The holidays are a time of year where the new bonds between missionaries truly coalesce into what can only be described as family ties. Teammates and national friends become “aunties” and “uncles.” New traditions emerge. It’s a beautiful thing to experience and witness.

To help illustrate some of this complexity and tension, I’d like to share a few anecdotes about two different Thanksgivings my family and I experienced while serving as missionaries in South Asia. One has notes of Currier and Ives. The other, not so much.

First, the good Thanksgiving. We’d planned the festivities with our friends for weeks in advance, and we eagerly anticipated our gathering. As the abbreviated day at the hospital wrapped up, my wife Ruth put the finishing touches on the lattice that topped her homemade apple pie and baked it to a golden-

people we had come to love nourished our souls. As I looked around, I felt deep affection for my friends who were gathered together, and I knew the feeling was mutual.

Even as Ruth and I enjoyed every minute of our time with this group of people we loved and served with, we still felt a twinge of ache in our hearts. We knew a similar celebration would be unfolding 7,000 miles away with our families and church community back home. And we wouldn’t be a part of it.

Yes, there would be Skype calls, with stories of the day and pictures of the kids exchanged, but we wouldn’t be there. In spite of the warmth and love of the evening, a little bittersweetness was there too, intermingled with the joy.

However, for some holiday seasons, sweetness and joy aren’t part of the equation. Instead, it just feels flat out bitter. Missionaries by no means have a corner on Thanksgiving thuds

Photos courtesy of Dr. Doug Lindberg.

brown perfection. We packed up the kids, the pie and the sweet potato casserole—comprised of potatoes grown just for this occasion, along with imported marshmallows—and headed to the celebration next door. The warmth and love that permeated our friend’s home as dinner approached that evening was as thick as the rich and delicious smells coming from their kitchen. A beautifully haphazard group of guests assembled through the course of the evening, bringing their own additions to contribute to the feast. Some of us had known and served together in ministry in this small village in the Himalayan foothills for years. Others had been there for only a few days. Americans, Germans, Brits, Swedes and Nepalis gathered together, most of us far from our families of origin but feeling every bit a part of the family atmosphere embodied that evening. The food nourished our bodies, and the keeping of a beloved tradition with 30 | CMDA TODAY | WINTER 2022

and crummy Christmases, but many who have served overseas can tell of doozies that could inspire another sequel of National Lampoon’s Christmas Vacation. That brings us to the bad Thanksgiving of 2012. Our family of four had been in the capital city for meetings for a week and needed to get back to the mission hospital as staff coverage was thin. I planned things out so we would begin our cross country, 20-hour journey back to the hospital early on Thanksgiving morning. This would allow us to make it by dinnertime to Travelers Rest, a special oasis known for their roasted chicken dinners and spotless rooms.

Things didn’t turn out how I planned. Our vehicle was delayed, and delayed, and delayed. We didn’t leave until mid-afternoon, and the roasted chicken dinner became an unrealized fantasy. The dreary weather and darkness hid the beauty of the

landscape. Carsickness made itself our companion, with all its accoutrements. Our Thanksgiving dinner was lukewarm lentils and rice in the dark, as power was out alongside the highway.

It was incredibly lonely and eerily quiet among our small traveling party. Thinking of the steaming turkey and mashed potatoes on the table back in Chicago, Illinois that day was pretty rough. Months later, Ruth begrudgingly offered forgiveness for the misadventures I led my family into that day, but not before securing solemn promises that such a trip would never be attempted on a holiday again.

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Give. If the missionary you support puts out a “Christmas wish list” for their ministry, help check a few items off it. Consider meeting these needs as gifts given in honor of someone close to you, and then you can put a card describing the gift under the tree. Perhaps you might even be willing to spearhead a Christmas giving campaign to fund a MedShare container loaded with medical supplies to be sent to a missionary’s facility, or you could organize a capital campaign to purchase a new operating room table or build a new emergency room.

Hopefully these reflections help you understand the value and importance of connecting with and praying for your missionary colleagues serving around the world during the Thanksgiving and Christmas season. It’s a challenging time, and encouragement from those they know and care for back home can really provide wind in their sails. Some missionaries are more open and forthright with their needs and challenges around the holidays than others.

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end a care package. Special items from home, including S special holiday decorations or treats, can be hard to find. You might also consider a cash gift to allow for a weekend getaway with their friends or family. If you don’t need the tax deduction, you can give these funds directly to missionaries through a personal check, bank transfer or PayPal, so they don’t need to pay taxes or administrative fees for the gift.

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ffer to help, however you can. Can you write grant reO quests? If so, offering your services would be the equivalent of gold, frankincense and myrrh for your missionary colleagues. If a missionary is on home assignment around the holidays or has recently returned from the field, ask them how you can help them. It might be babysitting while they shop or wrap gifts. It might be praying with them. It might be having them over to share in your family’s Thanksgiving or Christmas. This list could go on and on. Be proactive!

With that in mind, here are some practical suggestions of ways you can bless your missionary friends and colleagues during this special time of the year.

• Pray. And let them know you’re praying. Learn what their requests and needs are, and lift these up specifically on a regular basis. It’s so nice to know, while on the field, that others are engaged in the battle with you and have your back. Spiritual oppression and attacks are all too real in the places where healthcare missionaries serve, and prayer warriors willing to step into the fray are desperately needed.

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o and serve. A visit around the holidays can provide some G much-needed extra help and clinical coverage, and it allows for missionaries to have additional time with family and friends. This can be particularly helpful coming from “serial short-termers” who have visited before, as they know the lay of the land and don’t require extensive orientation upon arrival. It sure would have been nice to have someone covering the hospital so we could have stayed away for a few extra days and avoided the Thanksgiving disaster noted above! Shortterm teams, including teams from CMDA’s Global Health Outreach (GHO), create fantastic opportunities for outreach around the holidays, while providing valuable medical care and building rapport and trust with the surrounding community.

For more information about GHO, visit www.cmda.org/gho.

Go and teach. Medical education is always appreciated as well. Some mission hospitals have needs for formal instruction and trainee oversight through residency programs.

Plus, almost any place will welcome those who are willing to come and provide hands-on, bedside instruction and the occasional grand rounds talk to staff members. Opportunities for this sort of ministry are available through CMDA’s Medical Education International (MEI). For more information about MEI, visit www.cmda.org/mei.

May your holiday season this year be filled with thankfulness and reflection on the wonder that is Jesus taking on flesh, bringing hope to the world. As you celebrate, please remember your healthcare missionary colleagues serving around the world who are bringing hope and healing in His name. Make it a point to bless them as they seek to bless others. And by blessing them, you will help make this holiday season a true season of light around the world!

Doug Lindberg, MD, has served at CMDA as the Director for the Center for Advancing Healthcare Missions since 2020. He attended Loyola University, Chicago for medical school, completed a family medicine residency at Waukesha Family Practice Residency and then completed a one-year rural health fellowship at East Tennessee State University. The Lindbergs served in South Asia as missionaries from 2009 to 2013, and Doug served as the medical director for a mission hospital there. They returned to the U.S. in 2013 for what was intended to be a one-year furlough. However, a series of unexpected events, including his wife’s life-threatening cancer diagnosis followed by her miraculous healing, led them to relocate back to Wisconsin where they continue to reside. In addition to his work with CMDA, Doug works part-time clinically in urgent care. He and his wife Ruth are both family physicians, and they have two children, Maddie and James. He also enjoys running, hiking and coaching his son’s sports teams.

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Bioethics The Dr. John Patrick Bioethics Column

LOSING OUR LANGUAGE TO BUREAUCRATIC John Patrick, MD

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s is often the case, this quarterly column is heavily dependent on my current reading. This time it is Roger Scruton’s Fools, Frauds and Firebrands. Healthcare professionals are being pressured into all sorts of actions, actions which make them uncomfortable and undermine their deepest commitment to the good of the patient. Roger Scruton helps us understand why. Nevertheless, don’t rush out and buy it immediately, because this book is not an easy read without some considerable background knowledge, which busy healthcare professionals rarely have the time to acquire.

“woke” rule. The “woke-ists” want tolerance, but they do not practice it. How did this happen in one generation?

We all know there has been an epidemic of sexually transmitted disease since the 1960s with the liberalization of sexual activity and the divorce of sex and marriage. We all know that surgical removal of biological sex organs to affirm gender choice produces sterility and does not guarantee mental peace. We all know that children need fathers in their lives. Etc., etc., etc. Write your own list and send it to me, but this professional wisdom is not accepted by the anointed elite. Patients as clients are to be affirmed in every choice and prescribed what they want. Serious religious people are finding it difficult to maintain their moral integrity under this current

Epidemiology and public health, on the other hand, are intrinsically utilitarian in their ethics and statistical in their methods.

The person disappears and only a number is left. Outcomes are everything. Bad ones are simply collateral damage. Vaccines are an iconic example. Almost all vaccines injure some people, but eliminating a disease like smallpox was thought worthwhile by almost everyone, despite the risks. The population at large only knew this intuitively, but they trusted the medical profession implicitly. The management of COVID-19, plus media coverage, has once again severely damaged that trust. The arrogance of some of the main

32 | CMDA TODAY | WINTER 2022

Healthcare is a one-on-one activity. As such, healthcare professionals have been respected for centuries, despite having little effective therapy, because they recognized diseases and knew the prognosis, which allowed them to tell the truth and accompany their patients as far as the gates of death. This practice was solely concerned with the good of the individual patient, while the ethics governing that relationship used to be covenantal.

players beggared belief. The naivety of most of the politicians or, worse, their cowardice and unwillingness to say they didn’t know enough to make wise decisions compounded the disaster.

All this introduction is simply to point out that we need to educate ourselves and our patients in the language of ordinary human beings. Start by asking them whether they want a healthcare professional who has moral integrity or if they simply want treatment their way. Have W.H. Auden’s brief poem in hand: Give me a doctor partridge-plump, Short in the leg and broad in the rump, An endomorph with gentle hands Who’ll never make absurd demands That I abandon all my vices Nor pull a long face in a crisis, But with a twinkle in his eye Will tell me that I have to die.

This is not describing someone practicing half-baked psychology or meaningless empathy but a friend talking to a human being in a common parlance.

The elite ruling us are not malicious but ignorant, whilst thinking themselves much smarter than ordinary folk. In Intellectuals and Society, author Thomas Sowell points out that they would need to be at least 10 times wiser than the rest of us in order to have more collective wisdom. Most of them conflate wisdom and knowledge without even noticing. We all know uneducated folk who are wise and countless professionals who don’t know what wisdom is.

Once a group of people believe they know how to make everything better for everyone, they easily become obsessed with their own utopian dreams. Socialism is a utopian dream, which I bought into as a student and was instantly cured by a trip behind the Iron Curtain. The world experimented with communism more than 20 times in the 20th century, and it was a disaster in every case. Millions were sacrificed. To do the same experiment multiple times and expect different results is Albert Einstein’s definition of idiocy. (For more information, listen to Stephen Kotkin talking with Peter Robinson about Joseph Stalin on the Hoover Institution’s Uncommon Knowledge.)

By the time the 20th century was rolling along, left-wing intellectuals realized that Karl Marx’s prediction of the collapse of capitalism was wrong. Vladimir Lenin and Stalin had gained power by force and maintained it by fear in the Soviet Union. The ballot box doesn’t work for them. They turned their attention to the institutions, especially the universities, and they have succeeded in all, except the STEM faculties, having installed 90 percent left leaning faculty. Their students are fed propaganda and get jobs running the bureaucracy but are often totally incompetent with numbers.

Sowell has a wonderful story from the 1950s, when he was placed in the Department of Labor as a summer student worker. They didn’t know what to do with him, and so they asked him to find the data showing the effectiveness of minimum wage programs.

They knew they were wonderful, and they provided more work in the department than any other program, but they didn’t have the

data to boast about it. Trouble was, he actually found minimum wage laws were counter-productive. The officials were appalled and suppressed his work. Sowell was a Marxist at the time, but that summer experience started to erode his beliefs.

Here is a quotation from philosopher Roger Scruton in Fools, Frauds and Firebrands with which I am sure Sowell would agree: “Thinkers of the left don’t start with data but with their own ‘insights’ and then look for the data to support them. Often, they begin their critique of our social and political systems with an assault on the language [think Newspeak in Orwell’s 1984], as part of a far-reaching strategy to put power and domination at the top of the political agenda, while debunking the ways in which human relations are mediated by the search for agreement. Leftist Newspeak is a powerful tool; it wipes away the face of our social world, it describes the supposed reality that underlies the genial appearance and explains the appearance as a deception. Marx’s ‘material forces’, ‘antagonistic production relations’ and ‘ideological superstructures’; Foucault’s ruling ‘episteme’ and ‘structures of domination’ … all those mystifying technicalities have the purpose of confiscating reality from ordinary human understanding….”

The greatest task, therefore, is to rescue the language of politics: to put within our grasp what has been forcibly removed from it by jargon. It is only when we have again found the language that is natural to us that we can answer the great accusations that are being constantly thrown at our world by the left.

The young social justice activists wax hysterical over the wage differential between males and females without looking at hours worked; they talk constantly about patriarchy and domination without noting that their own parents don’t talk like that; and they pontificate about the horrors of slavery without noting that vastly more slaves went to the Muslim world where the men were immediately castrated, and there are more slaves in Mali and Sudan today than ever crossed the Atlantic Ocean—all facts which in no way condone the unspeakable nature of slavery.

Finally, if you have never watched 84 Charing Cross Road, do so.

You will see a realistic view of post-war Britain without any mention of power differentials, patriarchy or domination; instead, it is simply a culture that can only be understood by reference to the way Judaism and Christianity formed it.

John Patrick, MD, studied medicine at Kings College, London and St. George’s Hospital, London in the United Kingdom. He has held appointments in Britain, the West Indies and Canada. At the University of Ottawa, Dr. Patrick was Associate Professor in Clinical Nutrition in the Department of Biochemistry and Pediatrics for 20 years. Today he is President and Professor at Augustine College and speaks to Christian and secular groups around the world, communicating effectively on medical ethics, culture, public policy and the integration of faith and science. Connect with Dr. Patrick at johnpatrick.ca. You can also learn more about his work with Augustine College at augustinecollege.org.

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Classifieds To place a classified advertisement, contact communications@cmda.org.

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