Editorial
by David Stevens, MD, MA (Ethics) — Chief Executive Officer
Spiritual Ministry I went to the mission field to share the gospel through medicine. That is what missionaries do don’t they? But if that was the measure of my success, I was a dismal failure for the first year I was in Kenya. Medicine and language study consumed me. I was learning new diseases and new procedures and how to speak a language that could put seven parts of speech in one word. There were unlimited needs and very limited resources in personnel, hospital space, equipment, and medications. I was working twelve-hour-days and taking every third night call for 200 inpatients and a busy OB service. Don’t get me wrong. I was going to church. I encouraged patients to go to chapel each morning and made sure I wasn’t doing rounds during that half hour so they would feel free to go. I prayed before each of my surgeries. I was cheering on the ministry team, but I wasn’t really in the game. I had the head knowledge, but was distracted by other important priorities — you know, what doctors do — save lives, stamp out disease. And then God got ahold of me and shook my inner core as I took care of a terminally ill outpatient that I was trying to deal with too quickly so I could get on to the next one of the thirty patients waiting to be seen by me at 5 PM that afternoon. God put on the brakes and sent a celestial broadcast directly to my inner being, “David, why did I bring you halfway around the world? Was it just to cure disease? No matter how good a doctor you are, don’t you realize, all these people are going to die sooner or later? The only way you can help them find eternal life is to introduce them to Me!” I didn’t want to pull a Jonah and end up in the gastric pouch of a whale, so with the patient’s permission, I shared the story of Christ with that elderly man with the fungating retropharyngeal carcinoma ulcerating the side of his face, for which I had no treatment. I didn’t do it that well, but the Holy Spirit was more concerned about my willingness than with my ability. He did His work. Five minutes later, I found myself on my knees by the side of the examining table helping a patient pray the sinner’s prayer. His heart was changed and so were my priorities. This issue of Today’s Christian Doctor is focused on addressing patients’ spiritual needs, because God called you to be a missionary long before He called you to be a
doctor. He has put you in an office, a hospital, or emergency room — one of the best mission fields left in this country. You interact with patients every day who trust and admire you — people who are looking not only for answers to their physical needs, but for hope to hang on to and answers to the deepest questions of life. But perhaps like I was, you may be too busy and too focused on healthcare. Like me, you are not finding as much satisfaction in medicine or dentistry as you had imagined. There is something missing that successfully diagnosing and treating doesn’t provide. Deep down inside you know you are not involved enough in God’s process to bring your next patient to Christ, and the small part He may let you play in it. As I processed my own day of reckoning with Christ, I boiled down my ministry responsibilities to three principles that you may find helpful: • As a leader, I have the responsibility to ensure that spiritual ministry systems are in place and prioritized in my daily workplace. This is not going to happen unless I plan for it to happen. • I need to better train others on my healthcare team, and become better trained myself to share the gospel. • I need to lead by example — by routinely raising faith flags, telling faith stories, and testifying to what God has done in my life. You may own your own practice, or be an employee, or in a partnership that doesn’t share your spiritual priorities. All the same, the principles of spiritual ministry don’t differ from my mission hospital and your practice, though the applications of them likely will. You can train yourself, and perhaps other Christians. You can lead by example. And, where possible, you can put ministry systems in place. The real question comes down to this: Are you going to make addressing patients’ spiritual needs your most important priority? If so, read on. You will be motivated, trained, and equipped to carry out the Great Commission on your mission field. ✝
contents Today’s Christian Doctor
VOLUME 41, NO. 1
Spring 2010
The Christian Medical & Dental Associations® – Changing Hearts in Healthcare – since 1931.
11 God of All Comfort by Dee Brestin
Physician’s widow and best-selling author shares insights on how doctors can be better comforters
24 Ethics in Tension: The Christian Physician Sharing His Faith by Drs. Elizabeth K. Hensley and Samuel D. Hensley
It’s okay to share one’s faith with one’s patients within limits
14 Interview of a Patient by William T. Griffin, DDS
It was risky to turn down this patient’s request for pain-killing meds, but the Lord used this for her good
18 Education for Behavior Change — Three Important Stories by Daniel E. Fountain, MD, MPH
Behavior change in a patient depends on the degree to which you link your story with their story and God’s story
28 Character Counts Fourth in a Six-Part Series by Gene Rudd, MD
What you do is a function of who you really are
31 This is What I Worship by Phillip L. Aday, DDS
Opportunities abound for ministry through missions, but you never know what a patient might say
21 One Doctor + One Advocate = Hundreds Touched by God by Marc A. Hirsh, MD, and Lynn Eib
How one doctor’s vision transformed his practice
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Progress Notes Advertising Section
Regional Ministries
EDITOr
David B. Biebel, DMin
Current Events in Washington
EDITOrIAl COmmITTEE
Gregg Albers, MD Elizabeth Buchinsky, MD John Crouch, MD William C. Forbes, DDS Curtis E. Harris, MD, JD
Rebecca Klint-Townsend, MD Bruce MacFadyen, MD Samuel E. Molind, DMD Robert D. Orr, MD Richard A. Swenson, MD
VICE PrESIDEnT FOr COmmunICATIOnS
Margie Shealy ClASSIFIED AD SAlES
Margie Shealy • 423-844-1000 DISPlAy AD SAlES
Margie Shealy • 423-844-1000 DESIGn
Judy Johnson PrInTInG
Pulp CMDA is a member of the Evangelical Council for Financial Accountability (ECFA). TODAY’S CHRISTIAN DOCTOR®, registered with the US Patent and Trademark Office. ISSN 0009-546X, Spring 2010 Volume XLI, No. 1. 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 © 2010, 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,Tenn.
Highlights from CMA’s Washington Office Global AIDS: CMA met privately with President Obama’s Global AIDS Coordinator, Ambassador Eric Goosby, MD, and leaders of several other faith-based organizations to discuss the participation of faith-based organizations in the President’s Emergency Plan for AIDS Relief (PEPFAR). CMA’s VP for Government Relations Jonathan Imbody noted that the World Health Organization (WHO) estimates that between 30 percent and 70 percent of the health infrastructure in Africa is currently owned by faith-based organizations, and that the Gallup World Poll found that in nineteen sub-Saharan African countries, Africans say they trust religious organizations more than all other institutions. Mr. Imbody also stressed the importance of conscience rights in protecting the ability of faith-based professionals and institutions to continue to care for AIDS patients. Anti-Prostitution Requirement: CMA filed an official comment to oppose the administration’s proposed rule that would relax the requirement of explicit guarantees that US-funded grantees and sub-grantees oppose prostitution and trafficking in persons. CMA CEO Dr. David Stevens noted, “By allowing grant recipient ‘affiliated organizations’ to advocate for prostitution and sex trafficking, without jeopardizing the recipient’s eligibility for HIV/AIDS funding under the PEPFAR bill, the proposed rule simply accommodates groups that actually make sex trafficking worse through their pro-prostitution stances and advocacy.” Conscience Rights Video: CMA members Drs. Ali Ko Tsai and Sandy Christiansen participated in a video project to explain why patient access and care is severely diminished by failing to include adequate conscience protections in healthcare legislation and regulation. Produced by a professional firm in Washington, DC, the video is featured on YouTube.
Postmaster: Send address changes to: Christian Medical & Dental Associations, P.O. Box 7500, Bristol, TN 37621-7500. Undesignated Scripture references are taken from the New American Standard Bible. Copyright© 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977 by the Lockman Foundation. Used by permission. Scripture references marked (KJV) are taken from King James Version. Scripture references marked Living Bible are from The Living Bible© 1971, Tyndale House Publishers. All rights reserved. Scripture references marked (NIV) are from the Holy Bible, New International Version®. Copyright© 1973, 1978, 1984 by the International Bible Society. Used by permission. All rights reserved. Other versions used are noted in the text.
For membership information, contact the Christian Medical & Dental Associations at: P.O. Box 7500, Bristol, TN 37621-7500; Telephone: 423-844-1000, or toll-free, 1-888-230-2637; Fax: 423-844-1005; E-mail: memberservices@cmda.org; Website: http://www.joincmda.org. 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.
Dr. Ali Ko taping the video that is posted on YouTube
Other News Blogs: Jonathan Imbody’s blog (VP for Government Relations for CMDA) can be found at http://freedom2care.blogspot.com. CMDA’s weekly devotional blog can be found at http://cmdadevotional.blogspot.com. ICMDA XIV World Congress (Punta del Este, Uruguay – July 1-9, 2010): “Priorities in Professional Practice – For Whom are You Working?” is the theme for 2010’s conference. Speakers include: Dr. David Stevens, Dr. Pablo Martinez, Dr. Aldo Fontao, and author Philip Yancey. Visit www.icmda2010.org for more information. - Continued on Next Page -
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A great opportunity for fun, fellowship, and fishing, Nov. 18-21, 2010, with Dr. David Stevens hosting the event on the Watauga and South Holston Rivers located in Northeast Tennessee. No fly fishing knowledge or experience is needed as professional guides will be on hand to provide personal instruction. Special regulations and slot limits have blessed these rivers with a thriving population of resident trophy trout. This is your time to relax and meet your CMDA colleagues for a time of encouragement and recreation. Full details can be found at www.cmda.org/fishing. E-mail: stewardship@cmda.org, or call toll free (888) 230-2637.
New Media Update: CMDA regular updates can be found by joining our Facebook Fan page or following us on Twitter. We now have our own personalized URLs, which makes it easier to locate us. Visit: www.facebook.com/cmdanational and www.twitter.com/cmdanational.
Life Support: Starting its fifth year, Life Support is a great audio resource produced specifically for meeting the unique needs of students and residents. It can be used for small groups and chapter meetings and is absolutely free. Past issues include interviews on integrating your faith into every aspect of your life, picking your residency program, finding your mate, how to stay a Christian in school, making time for family, dating and preparing for marriage, missions, sharing bad news, and much, much more. In addition, a series on specialty sections with interviews on dentistry, emergency medicine, pathology, psychiatry, internal medicine, OB/Gyn, and much more can be found by going to our website at www.cmda.org/lifesupport or through iTunes. If you have a topic you are interested in or someone that you would like to recommend for a future interview, send an e-mail to communications@cmda.org. 6
T o d a y ’s C h r i s t i a n D o c t o r
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Coming to CDD: Watch for upcoming Christian Doctor’s Digest interviews with Ruth Graham about her new book “Fear Not Tomorrow, God Is Already There,” Dr. Ken Gregoire on Valley Hope Rehab program, Dr. Bill Bevins & Dr. Stephen Muhudhia on Medical Education International’s impact in Kenya, Dr. Lowell Becker talking about growing better families, and Dr. Richard Swenson’s latest release on balance in your life.
from the
CMDA
President
George Gonzalez, MD
Ministering to Your Patients’ Spiritual Needs Do our patients notice a difference between our practice of medicine or dentistry, and what they might receive from a doctor who denies Christ? Though our diagnostic evaluation and therapeutic treatments should be similar, there certainly could be significant notable differences, depending on our faith and ministry skills. As Christian doctors our greatest asset is not head knowledge, but a transformed heart. Our greatest resource is not a textbook or the Web, but the Holy Spirit (John 14:12). To be a Christian doctor, we must ask the Holy Spirit to fill us with wisdom and power to help and encourage others (James 1:5). In 1 John 5, a Christian is defined as one who loves and obeys God the Father and Jesus, His Son. The world knows us by our love for others (1 John 4:7). Do our patients really believe we love them? In the “real world” we are mostly just trying to make it through the day without making any significant errors. We are rushed for time and annoyed by inconveniences. Some patients are demanding and draining. At the end of a long day, we are left with little for others including our families. Without asking God to give us wisdom and that we be guided by the Holy Spirit in diplomacy, we can easily get burned out. Though I certainly do not exemplify the perfect Christian doctor much of the time, God has been gracious to use me to profoundly affect the lives of others. Sometimes it has been as simple as making the correct diagnosis and treatment, but most often it is through taking time to pray with a patient that I’ve later received the most feedback in terms of changed lives. An extra thirty seconds to pray for someone returns great dividends (James 5: 15-16). Thank God, the Holy Spirit is not dependent on our strength and holiness to do a good work. I often will share my faith with patients who may or may not respond to a point of commitment to Christ. But I’ve seen even how wearing a cross on my lapel has triggered the interest of one young lady who later asked
her mother to explain the meaning of the cross, after which she gave herself to Christ. In my business, and perhaps in yours, the dilemma is how to remain sensitive to the spiritual needs of our patients and stay on schedule. First, I’ve resolved that the schedule is not my master but a tool. Second, I have learned to use others in the office to pray with and care for the patients. Don’t make it your responsibility to be everything to all people. Refer to Christian counselors and churches and have plenty of Christian literature — such as plans of salvation, gospel booklets, and appropriate tracts — available. Short-term mission projects have helped me gain perspective in the care of the whole person. In my practice, medicine is often pure business, but when out in the mission field my goal is not to treat and bill to get income, but to share the love of Christ so as to open hearts to receive the life-giving message of the gospel. On the mission field it is so clear that what we have to offer as physicians is temporary, but what Christ (The Great Physician) has to offer is eternal healing. It certainly sets the right priorities for our office practice. I, and most likely you, miss opportunities to represent Christ to others on a daily basis for many reasons, not the least of which is busyness. I sometimes wonder if I would be the Priest, the Levite, or the Good Samaritan to the wounded man on the roadside to Jericho. We all fall short at some point in our service, but God is gracious. I find that if I pray each day for God to open my eyes to see the need and for Him to use me, He is faithful to do so. Our confidence is in Him, not in ourselves, to adequately meet the spiritual needs of our patients. We don’t need to be doctors of great faith, but to have faith in a great and providential God knowing each appointment could be a divine appointment. ✝
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Global Health Outreach (GHO)
Photo by Dave Bushong
Manual Small Incision Cataract Surgery Workshop Held
Wet lab practice was an essential component of the workshop
Haiti Earthquake Relief If you are interested in participating in Haiti’s relief assistance, go to www.cmda.org/haiti for current opportunities from CMDA and its partners.
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For InFormatIon about GHo opportunItIes, VIsIt: www .cmda.orG/GHo
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On January 16, 2010, GHO sponsored a workshop at CMDA headquarters in Bristol, Tennessee, which was attended by eight ophthalmologists and three instructors. The program was supported by Alcon and TrueVision (Alcon supplies surgical tabletop microscopes and surgical disposables; TrueVision supplied some of the videos and 3D surgical training material). After a didactic session, a wet lab was done to practice the surgical technique. This event was held because a focused review of post-surgical cataract patients in Mexico and Ghana revealed that the number of good post-surgical results were below WHO guidelines. An evaluation determined that most of the surgeons were not familiar with and did not use the optimal procedure for mature, welldeveloped cataracts seen most often in developing countries, so an excellent and inexpensive technique was needed in order to increase the quality of care.
“It is a great joy to see healthcare professionals carry the banner of Christ with excellence in all that they do,” said Samuel Molind, DMD, Director of GHO. “This program will help the blind to see, improving their physical sight and their spiritual vision as well — to God be the glory.” GHO plans to continue these programs once or twice a year to enhance the surgical procedures available to our ophthalmologists as they serve in developing countries. An ophthalmology mission is scheduled April 24 – May 2, 2010, after which postsurgical patients will be reevaluated at one day, four weeks, and one year, to determine outcomes.
Medical Education International (MEI)
Long-Time MEI Leader is Recognized for His Service by Dr. Jim Smith, Chair MEI Advisory Council
On his way back from his most recent Kosovo MEI mission, Dr. Jonathan Askew, long-time CMDA member and Kosovo Project Leader, was honored by Taylor University with the Distinguished Alumnus for Personal Achievement Award. He is a 1965 Taylor graduate. He and his wife Harriet have worked overseas in a number of countries and roles. In recent years they have spent about half their time in Kosovo and have organized and led many MEI teams to assist Kosovo medical colleagues. In the spring of 2009, he taught along with another MEI physician at the first Hospice and Palliative Care Conference held in Kosovo, which introduced important topics to about 250 medical colleagues via on site and teleconference connection. Dr. Jonathan Askew (r) receives award from CMDA member Dr. Neil Smith
For InFormatIon about meI opportunItIes, VIsIt: www.cmda.orG/meI
After losing her 59-year-old husband to cancer, Dee Brestin wondered if her life was over as well. She ached for God’s comfort, but felt utterly alone. Then He showed her what suffering souls through the centuries have learned: Psalms and classic hymns speak the truth to a grieving soul. The truths carried by some of these timeless songs, the lyrics of which Brestin includes in this book, can calm the most fretful spirit. They invite the wounded heart to be quiet before God, to rest like a child in the arms of a loving parent. Each of us must travel down roads of bereavement, betrayal, and broken dreams. The God of All Comfort will help readers find their way into the arms of God. With compassion and spiritual wisdom, Brestin draws on the difficult beauty of her own story as well as her skills as a Bible teacher to offer companionship, comfort, and hope. One reader wrote, “It really has helped me to see how much I’ve relied on myself and things of this world rather than my faith and the comfort found in the truths of the Word of God.” Hardcover. 265 pages. $16.99
The God of All Comfort Finding Your Way Into His Arms by Dee Brestin
One way of addressing your patient’s spiritual needs is to minister to them in their grief over the loss of a loved one. Here are some other books that might be helpful: Hope for the Brokenhearted – $14.99, Holding On To Hope – $12.99, Treasures of Darkness – $12.95, and See You Later Jeffrey – $7.00.
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God of All Comfort by Dee Brestin
Helping a heartbroken patient takes more than a few words of advice. Sometimes it takes no words at all.
M
y 59-year old husband Steve, the father of our five children, and a beloved physician in our town, lost his valiant battle with colon cancer. Though you never completely recover from a catastrophic loss, you can experience comfort and transformation. It isn’t just the passage of time that has brought healing to our family, but understanding how to “hoist the Psalter sail,” to use the Psalms to take us through this raging river of grief. This is a secret suffering saints throughout the ages have discovered: from Basil, to Bonhoeffer, to Bono — and yes, to Brestin — a simple daughter of God. Use the Psalms incorrectly, and you will sink — but use them correctly and they will sail you through the stormiest sea. Philip Yancey said that he had been told to go to the Psalms for comfort, but when he did, he would end up reading one of the “wintriest Psalms” and end up feeling “frostily depressed.” How comforting, for example, is this? Your wrath has swept over me; your terrors have destroyed me. All day long they surround me like a flood; they have completely engulfed me. You have taken my companions and loved ones from me; the darkness is my closest friend. Psalm 88:16-18
But then Yancey came to understand that the Psalter is not a book about God, but a journal written to God. We do not read it like the other books of the Bible. Instead, we use it to help us dialogue with God. The Psalms of lament freed me to be honest with God, for the Psalms reminded me to avoid the trap of dishonesty with God. God isn’t angry when we are honest — instead, what angered Jesus repeatedly was
dishonest people pretending to be something they were not. God wants honesty, because He wants intimacy with us. My husband was the first of us to fall in love with the Psalms. The following is an excerpt from my prayer journal: December 13 Five years before Steve’s death Steve is taking long earnest strides with You, Lord, and I am running breathlessly behind, trying to catch him. He has read through the complete set of Charles Spurgeon’s The Treasury of David this last year. We read together, last night, by the crackling fire and the Christmas tree, and when he finished the last volume he closed it reluctantly, held it close to his heart, and said, “I have spent this year in the presence of a very godly man.” I find, when we pray together, phrases from the Psalms lace his prayers: “According to thy tender mercies . . .” “We forget not all your benefits . . .” He loves to sing hymns and Psalm songs. Annie, whose bedroom is below his den, says “I hear Dad singing songs in the night. I like it.” Thank You, Lord. I believe that our merciful God, because He knew the storm was coming, was preparing us to hoist the Psalter sail. Steve kept paperback copies of the book of Psalms in his desk, and would give them to patients with a simple explanation that these Psalms could help them pray both in times of joy and in times of pain.
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PRACTICAL WAYS FOR PHYSICIANS TO “SIT SHIVA” When you deliver bad news, do it privately and in person. Sit down. Answer their questions, giving them time. Acknowledge their shock. “I know this is a lot to process and you may have more questions later.” Acknowledge their pain. Often, “I’m so sorry” will suffice. Sometimes articulating their pain is so helpful. When I was a distressed first-time mother with a colicky baby, my pediatrician told me he had colic and probably wouldn’t get better for three months. I began to cry. She came over, put her hand on mine, and said, “The constant crying is so hard, isn’t it?” I nodded. “I know it feels like it will go on forever, but it won’t.” I left feeling comforted. I felt she understood my pain, and somehow, that divided it. Walk them to the door. Physical touch — an arm around the shoulder, an embrace at parting, even a touch on their arm can identify with their pain. Pray simply. My husband prayed with every patient, and in his whole career, was only refused once. A simple prayer for God to comfort and to help is sufficient. Steve kept a large drawer full of paperbacks of the Psalms to hand out. He bought them in bulk. He also had a drawer full of musical CD’s. Music is a wonderful way to “Sit Shiva.” The Psalms and the great music of the church have the power to calm, and to drive evil spirits away. Here are a few specifically designed to bring comfort: • Both of these guides have a comforting music CD in the back: “The God of All Comfort” and “A Woman of Worship” (www.deebrestin.com) • Michael Card, “The Hidden Face of God” (www.michaelcard.com) • Matthew Smith, “Even When My Heart Is Breaking” (www.igrace.com)
During our storm, the Psalms of praise stuck in my throat — but oh how I could identify with the Psalms of lament. Through them I sensed that the Lord Himself understood my pain, my grief. The lament helps you hang onto God — to accept the mystery of suffering. In most of the Psalms of lament, it begins with an honest cry of pain, but usually, there is a shift before the close of the Psalm, when the psalmist is able to turn his eyes from his own situation to the character of God, and resolve to trust. For example, in Psalm 13, David begins by lamenting: “How long, O Lord? Will you forget me forever?” But by the close of the Psalm, though his circumstances have not changed, the Lord has given him strength, for he says, “But I trust in your unfailing love . . . .” What the enemy has tried to get us to do, from the Garden of Eden on, is to back away from God. And when you are suffering, he comes slithering in, whispering lies. The Psalms of lament are the antidote, helping you defeat those lies, helping you hang on, helping you know God understands your pain. In fact, through the Psalms of lament, God “Sits Shiva” with you. “Sitting Shiva” is a Jewish tradition. When someone had a catastrophic loss, close friends and family would “Sit Shiva” with them. “Shiva” means seven, which is the biblical number for completion, or, in effect, “as long as it takes to bring comfort.” They would come and sit, but not speak unless spoken to, and then only briefly. They would listen to the person share the details of their loss, they would weep, but they would not offer solutions. When author Joe Bayly’s child died, he told of two very different visitors: I was sitting, torn by grief. Someone came and talked to me of God’s dealing, of why it happened, of hope beyond the grave. He talked constantly. I wished he’d go away, and he finally did. Another came and sat beside me. He didn’t talk. He didn’t ask leading questions. He just sat beside me for an hour — or more. He listened when I said something. He listened. He answered briefly. He prayed briefly, and then he went away. I hated to see him go. Sometimes we simply cannot shield children, loved ones, or patients from enormous pain. I wanted to prevent my five children from suffering, from losing their dad — but I couldn’t. What I could do was stand beside them in their pain, mourning with them. I could also pray for them, entrusting them into the arms of God. Though God did not rescue our family the way we first hoped, by healing Steve on earth, He has rescued us. None of our children have backed away from God, but have used the Psalms of lament to talk to Him, to help carry them through the storm. As the years have passed, I am seeing a real rescue. God has enlarged the souls of each of my
Suffering has a purpose so deep we may not understand it on earth. But in the midst of mystery, we are refined. In the midst of questions, we come to a deeper trust in the One who knows every answer, in the One who laid down His very life for us. And as we speak the truth to our souls, using the Psalter sail, we overpower the enemy. God’s Spirit not only rescues and comforts us, but transforms us. ✝ Bibliography 1
children. The “God of All Comfort” has comforted them, and now they are comforting others with the same comfort they have received. June 7 Three and a half years after Steve’s death I just talked to Annie on the phone. Oh, Lord — what a transformation You are doing in our daughter! She is telling me about her work at the hospital as a nurse’s aide. She said, “Half of what I do is cleaning up after people who have been sick. But Mom, I think it is what I was born to do. I can be the love of Christ to them and that brings me so much joy.”
2
Philip Yancey, The Bible Jesus Read, (Grand Rapids, MI: Zondervan, 1999), p. 109. Joseph Bayly, The View From A Hearse, (David C. Cook Publishing, Elgin, Illinois, 1969) pp. 40-41.
Dee Brestin is a bestselling author and speaker. Her latest book, The God of All Comfort: Finding Your Way into His Arms (Zondervan) shares her grief journey after her husband’s death, and how the Psalms of lament took her through the storm. Steve Brestin was a leading orthopedic surgeon in Nebraska who practiced with three other Christian orthopedists. Author Carol Kent wrote: “This book will be an instant classic for those who are hurting.”
God of All Comfort
Oh Lord, thank You. I’m hoping Steve can see her. But if he can’t, will You tell him, please?
IntervIew of a PatIent by William T. Griffin, DDS
Photos courtesy of Dr. Griffin and Crystal
Speaking the truth in love can have a transforming effect
Editorial Note: This article presents, via interview format, an interesting behind closed doors look at how one doctor successfully ministered to the spiritual needs of one of his patients. Introduction Crystal was 16 when I first began seeing her. A high decay rate made her a regular visitor to my dental practice. In recent years some of those cavities had gotten dangerously close to the nerves in her teeth, eventually necessitating two root canals and much sensitivity over the years. After her last several visits she had requested prescription medications on multiple occasions. When a patient requests pain medicine, it can create a bit of a dilemma for the doctor. While we want to be compassionate and do what we can to ease their pain, we also don’t want to contribute to the development of a physiological or psychological dependence on mind-altering medications. In Crystal’s situation, my suspicions had reached the point where I determined that the most loving thing I could do was to deny her most recent request for a prescription. I sent a letter to her, explaining my rationale for not writing the prescription she claimed to need, and I also informed her that I would not be able to continue as her dentist unless I was given the opportunity to treat the alleged source of her pain. This was a hard letter for me to write. I knew that Crystal had lived a difficult life, with more than her share of heartaches. During her nine years as my patient, the Lord had given me several opportunities to share various aspects of the gospel with her. Up to that point, however, I had not seen any significant evidence that the gospel was resonating with her, and my letter could have very well severed our fragile doctor-patient relationship altogether. The Lord had other plans in mind for Crystal, as I found out a few months later. He used the circumstances in her life to break her down and show her the need for a Savior. Just four months after I had expressed my reservations about her requests for prescriptions, she had become a new creation in Jesus Christ. The change in her was undeniable, as attested by her peaceful countenance and overwhelming gratitude for God’s grace in her life. Below are excerpts from an interview I had with her on October 9, 2009: _____________________________________
William T. Griffin (WTG): Crystal, tell me about your faith experience as you grew up.
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Interview of a Patient
Crystal: My grandmother raised me and I grew up in the church. I grew up in a private school so I knew all the basics — I learned a lot about the Bible and memorized a lot of Scriptures and I learned a lot about God, but never really sought Him myself. WTG: Did anyone ever explain the gospel to you in a way you could understand? Crystal: I had a lot of teaching on the gospel. I understood the gospel; I just didn’t make it personal. WTG: Now, prior to becoming a Christian, were there any Christians in your life that caught your attention in either a good or a bad way? Crystal: This practice caught my attention a whole lot. When I came in here, I wanted what you and the nurses had. Most other Christians that I came across knew a lot and preached to me, but there wasn’t that spark, that light that shined through when I entered this office. The love of God was through the whole office. I could definitely see that in everybody. I knew that it wasn’t just a dental office where it was only about dental health. I knew there was something more to it. In a spiritual sense you really cared about showing the love of God and that meant a lot to me. That wasn’t something I came across even in some churches I had been to. WTG: Do any particular memories of dental experiences in this office come to mind? Any particular appointments or anything like that? Crystal: When I had my oldest son who is 8 now, you gave me a book, More Than a Carpenter. You didn’t ask me to buy it; you just gave it to me as a gift. So I read that book and it touched me, and I think that for a little point in my life it changed me. That was seven years ago. That book taught me a lot and gave me a different view on Christianity that I hadn’t had yet. WTG: You might remember, early this year I had seen you a couple of times for some difficult treatments and deep cavities and you had asked for prescriptions afterwards and it got to the point where I didn’t think it would be in your best interest for me to write you those prescriptions. Do you remember that situation? Crystal: Yes. WTG: To what extent were the prescriptions needed for dental pain, or was there another motivation involved also?
Crystal: It had gotten to the point where the prescriptions were to get high on, but in my head I wanted to say, even to myself, I’m feeling pain so I don’t want to feel pain. But I was over-exaggerating the pain because I was in an addiction. Alcohol was my main addiction, but I used anything that could get me high, because my husband and I had just separated, and I didn’t want to deal with my issues and problems at the time. That was a type of an escape. So it was a deeper issue than dental pain. It was more emotional pain that I was trying to cover up. WTG: Well, you know the beautiful thing is that we have done some deep fillings on you since and, by the grace of God, you’ve needed nothing. You know I think mindset has a lot to do with it. It’s neat to see how the Lord has dealt with that. Crystal: Right, and the Lord has explained to me that I don’t need any mind-altering substances. WTG: When I sent that letter to you, explaining that I wasn’t going to able to be writing you any more prescriptions, how did it hit you? How did it affect you? Crystal: It hurt. It hurt a lot because I knew then that my dependence on drugs was getting more obvious. My family knew that I had addiction problems, but now my dentist was seeing it and he was acknowledging it, which hit hard. It hit very hard. WTG: I’m sure it was difficult for you, and it can also be a difficult thing for a healthcare practitioner. Often I
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Interview of a Patient
wonder whether prescription medication is really needed or not, but I almost always err on the side of giving the patient the benefit of the doubt. Crystal: Right, I can see how that could be a hard decision. WTG: Tell me about how the Lord got your attention and how you came to Christ. Crystal: Unfortunately, it took me sitting in a jail cell to realize that I no longer could control my life. It wasn’t something I could do on my own any more. You know, a failed marriage, I lost my son, and my grandmother who had raised me my whole life and I was her princess and could do no wrong, couldn’t even stand for me to be in the house because she didn’t trust me. And, all my relationships around me were falling apart. I’d lost my home, lost everything . . . so it took me to get to the bottom of the hole to finally realize that I had no control. I couldn’t lead my life. I knew that it was time to allow Jesus to be the leader of my life.
know that He has great plans for me to prosper me physically and spiritually and every type of way. I’m so excited about it and I’m so excited just to get to know Him and seek Him. I’m excited about life. I didn’t love myself before, but now I love who I am in Christ. Before, I hated myself and I was not a happy person. I didn’t like anything about me. Things are really different now. WTG: It’s amazing to me how, if we try to change ourselves, we end up short, we end up weak. It’s just too hard to make it happen. But when we just receive God’s love, that love changes us from the inside out and gives us something to like about ourselves. Crystal: And it does. It’s so awesome. WTG: Crystal, do you have any advice for Christian doctors regarding how they can best minister to their non-Christian patients? Crystal: I would say to let the light in them shine through, you know, what you guys do so well here, because it just shines right through you. Even with all the business that’s going on, and all you have to do, you still have that light shining through you. A person can see God all over you. And, that warms even someone who is not a Christian . . . it warms their heart. I know they’ve got to feel it. So in everything that you do, do it so that it glorifies God. Then the love of God for others will shine through you, and even if your patient is angry, they will still see it and want it for themselves. __________________________________
What I learned, or was reminded of, through Crystal’s experience.
WTG: Wow. There are a lot of patients that I wish could hear what you’re saying right now. Since you’ve established your relationship with Christ, what’s life been like? You’re smiling . . . . Crystal: Well, first I had to admit that I had no more control of my life. I feel so much better now . . . I have the best person in the world in control of my life now. So I have no worries because all my trust is in Him. He’s going to handle it and His way is better than my way. My way got me into a jail cell and a divorce, but now I
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Cultivate a staff that seeks to love others, above all else. Every office must include technically competent professionals, who know and do their jobs with excellence. Such competence, however, will fall short of proclaiming the love of Christ, unless there is a concurrent zeal to consistently show love to each patient who walks in your treatment room. This love cannot be withheld from those who don’t seem to deserve it; otherwise, we have denied the gospel we seek to proclaim. Romans 5:8 says, “But God demonstrates His own love toward us, in that while we were yet sinners, Christ died for us.” Seek opportunities to show grace to your patients. Whether it’s a free book, a children’s Bible song CD, gift cards, a patient appreciation dinner, a get well card, or
efforts don’t always turn out like this. Sometimes we sow the seed, sometimes we water, sometimes we see a harvest — but it is all God’s doing. Our role is to be faithful, to show the love of Christ to every patient, and pray that the Lord will use the efforts of His people to change hearts. 1 Corinthians 3:6 says, “I planted, Apollos watered, but God was causing the growth.” ✝
William T. Griffin, DDS, has been a member of CMDA since 1982. He practices general dentistry in Newport News, Virginia, along with working at a local Christian medical-dental clinic and going on two to three dental mission trips a year. Dr. Griffin is a member of the CDA Dental Advisory Council, and a frequent contributor to Today’s Christian Doctor. He and his wife, Linda, have two children, Katie and Will, who attend the University of Virginia. He may be reached at: williamgriffindds@gmail.com.
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praying for a patient’s medical or non-medical needs, imitate the Giver of all good gifts by surprising your patients on a regular basis. James 1:17 says, “Every good thing given and every perfect gift is from above, coming down from the Father of lights, with whom there is no variation or shifting shadow.” Give patients what they need, not what they ask for. When we deny a patient’s request, in whatever the context, we risk alienating that patient. This doesn’t just apply to prescription drugs, it can also be that patient who wants a mouthful of veneers when what they really need is orthodontic treatment. We are doctors, not used car salesmen, and as such we have a responsibility to use our professional knowledge for the betterment of our patients, regardless of what they might request. Proverbs 27:6 says, “Faithful are the wounds of a friend, but deceitful are the kisses of an enemy.” “Proclaim the gospel at all times, and use words when necessary” (St. Francis of Assisi). It is such a privilege to see a patient come to Christ, to see “the old things passed away; behold, new things have come” (2 Corinthians 5:17). Of course we all know that our evangelistic
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Education for Behavior Change Three Important Stories by Daniel E. Fountain, MD, MPH These are separate stories and we must make them intersect. To bring about changes in understanding and eventually in behavior, we must find links between these stories. These links will permit the interchange of ideas and the transmission of knowledge, values, and beliefs that can result in positive behavior change. Why is God’s story important in this area of health-related behavior? Because most people interpret illness as a spiritual issue as well as a physical one. Why am I ill? What has gone wrong in my life? Where is God in this situation?
Their Story
M
otivating people to change their behavior is difficult. We hang tenaciously onto our habit patterns because they have deep roots in our cultural values and beliefs. We spend a considerable portion of our limited consultation time telling patients they need to make changes in their behavior: more exercise, less fat or salt, eliminating tobacco or alcohol, or spending more time with their family. Yet we so often see the same people again without improvement because no change in behavior has occurred. Think how much of our time has been wasted. Is there not a better way? In spite of all the training we have received in health education, we seldom succeed in bringing about lasting changes in the behavior of people. This is largely because we do not get to the underlying beliefs and values of people that determine their behavior and thus cannot help them to reflect on them and their need to make changes.
Three Stories In working with people on an issue of behavior change, be it physical, social, or moral, three stories are essential: what they have to tell us: their story what we want to tell them: our story what we want them to learn of: God’s story
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Our Story
God’s Story
The starting point in this process is to understand where our patients are coming from. Many are fatalistic — “It’s all God’s will;” “My disease is genetic;” “It’s just my bad luck.” They resist taking a personal initiative in the healing process, and they want medicine to take full responsibility for the healing. Unless we know what is in the mind of each patient, we cannot orient our counsel in ways that will be effective. How can we know their thinking? Only by first listening to their story. We must listen with discernment and try to identify key elements in it: their strengths – what has worked for them in the past or is now working to benefit them what they seem to lack – knowledge, understanding, skills obstacles to healing – fear, anger, guilt, painful relationships, and so on links – entry points for elements of our story or God’s story so that we can fit into their story ideas and help them reflect on their life.
Strengths Weaknesses
Links or Entry Points
Low salt
Fatalism
Cynthia, a family nurse practitioner, asked Amanda about her personal life and faith. Amanda assured her she believed in God and that God was in full charge of her life. Her previous physician had warned her about salt, but she knew she would die when God called her home and saw no need to cut back on her salt. Her times were in God’s hands. Again fatalism. Cynthia replied that she was happy to learn of Amanda’s faith in God, for that is so important for our life and health. She explained that God wants us to be healthy and to have a long life. To that end, He has given us many laws which, if we follow them, favor health and long life. Some of those laws we find in the Bible. Medical science has discovered many others, for science studies what God has made. She told Amanda how God has made our bodies with a beautifully balanced internal harmony and that salt is necessary to maintain this. But if we eat too much, especially when the heart is not functioning well, the extra salt can produce an imbalance and lead to increased blood pressure and other problems. So the rules about how much salt to eat are God’s rules that medicine has discovered.
God wants us to be healthy
God wants us to eat the right amount of salt
Amanda expressed surprise at this information. She never knew that God was concerned about salt, and all that we eat. She now understood that God expected her to cooperate with the way He had made her, and her eating habits changed. Dr. John told Mary his story without taking time to listen to her story — her understanding of life. Mary did not change because John did not look for an entry point into Mary’s worldview that would help her understand the importance of what he was saying.
Cynthia first listened to Amanda, and as she listened, she understood her fatalistic worldview. However, Amanda’s belief in God was the link to the story Cynthia wanted to give her, the story about dietary salt. Amanda’s real problem was a faulty understanding of God. In other words, her theology was an obstacle to her health. By linking Amanda’s story with God’s story, Cynthia enabled her to understand Cynthia’s story about dietary salt. Mr. L was the principal of a Christian high school in a large urban center in the Congo. He came to our hospital with a four-month history of vomiting and diarrhea and a weight loss of forty pounds. He had found no relief in spite of care from numerous physicians in his community. Aside from severe weight loss, no significant physical findings were present. Nor were there any abnormal laboratory results, including his Elisa test for HIV, which was negative. In response to my question about how things were going in his work, he indicated everything was fine. But his manner of replying raised a suspicion that he had real problems in this area. I suggested that, as we proceeded with various examinations and symptomatic therapy, he should talk with our pastoral counselor, and he agreed. The pastoral counselor took a history of his illness and then began inquiring about his personal life. She discovered the following:
Education for Behavior Change
Dr. John, a family practitioner, explained carefully to Mary the dangers of salt in relation to her hypertension and early congestive heart failure. After hearing her doctor’s recommendations, she replied, “Doctor, my life is in God’s hands. If He wants me to live, I will live. If He wants me to die, I will die. So I am going to eat as much salt as I wish.” Her real problem was fatalism.
Strengths – He had been a good teacher and now was doing a satisfactory job as school administrator. He had a good marriage and three children who were doing well. Weaknesses – He seemed quite fatalistic in his approach to his illness. God was punishing him for something, and he could do nothing about it. Needs – The counselor asked a question about relationships. “Are there any people you work with whom you find difficult?” At this point Mr. L erupted in anger. “Why are you asking me such a personal question?” The counselor replied that she was asking questions about many different matters in order to discover how best we could help him. Mr. L then burst into a vitriolic attack on the school superintendent and the head pastor of the church that ran the school. “Unjust men, always trying to destroy me,” he blurted out. As he did so, he vomited and had to excuse himself to go to the restroom. The counselor now knew his problem — anger — but also knew he had no personal resources to handle it. She also had to find an entry point into his feelings through which she could bring help to him. She sent him back to his room and scheduled another meeting for the next day.
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Education for Behavior Change
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Links – During the next consultation, she inquired about Mr. L’s relationship with Jesus. Again he became angry. “How can I believe in the Jesus whom these evil men are always talking about?” The counselor assured him she was not asking about the Jesus of these men, but rather the real Jesus. “Who is the real Jesus?” he demanded. As she began unfolding the story of Jesus, Mr. L moved closer and listened intently. He had never heard such things about Jesus. When the counselor asked Mr. L if he would like to invite Jesus into his heart, he agreed and quietly prayed to invite Jesus into his life. He immediately relaxed and a new light came into his eyes. The counselor returned to the painful personal relationships and read to Mr. L what Jesus said we are to do with those who harm us. She asked him if he could forgive these men. His answer revealed a surprising insight. “I now see that these men are not my problem. My real problem has been my response to them.” The counselor asked him if he could forgive himself, and he was able to do that. When he returned for further medical examinations, it was evident he was a changed person. The vomiting and diarrhea had stopped. He was now eating well and had regained five pounds. He returned home and to his work, determined to build better relationships with his superiors. Here was a man who presented with symptoms of a serious physical illness. The initial examination failed to point to a physical diagnosis, but by observing his response to a personal question, I suspected there were underlying problems in his life. Because we had a competent pastoral caregiver as a member of our healing team, investigations began in this area while further medical tests were being done. Such a team approach — medical and pastoral — provides additional resources for ferreting out personal problems that often underlie serious illnesses.
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The counselor found out his strengths — his abilities and support structures. She also discovered the fatalistic approach so many people have toward their health. The real need in this man’s life surfaced suddenly when she inquired about interpersonal relationships. Anger was the etiological factor in his illness and his need was to find the resources to deal with it. Bad theology was an obstacle to his health. As she sought for a spiritual link, the counselor discovered that this man was angry with his superiors who were proclaiming a religion he could not accept and were using it to create tension for him. The counselor, however, quickly realized that his understanding of Christ was distorted by his relationships with these men. When she helped him understand his need of a personal relationship with Christ, who can help us resolve the inner tensions, conflicts, and anguish of the heart, the man was healed. These clinical accounts demonstrate clearly the interaction of the three stories. Dr. John simply told his story and got nowhere. Cynthia listened to Amanda’s story and discovered how to bring into her understanding the story about salt she needed to hear. It was God’s story that made that happen. Mr. L did not need a medical story. Understanding God as He really is, and then seeing himself and what needed to change in his mind, was sufficient to resolve both his anger and his physical illness. As his story unfolded, the counselor found his point of need. She was then able to work through the entry point of his distorted knowledge of Christ to lead him into a relationship with Christ, which enabled him to resolve his inner conflict. Can the “three story approach” happen in a busy practice? Yes, if we can discern when personal problems are part of an illness, and if we have people trained to listen, discern, and link the medical story and God’s story with the entry points into the sick person’s way of thinking. ✝
Daniel E. Fountain, MD, MPH, earned a doctorate of medicine from the University of Rochester School of Medicine. He continued his education with a residency in surgery, obstetrics and gynecology at the University of Alabama Hospital in Birmingham. Dr. Fountain earned a Diploma in Tropical Medicine at the Prince Leopold Institute of Tropical Medicine in Belgium. In 2006, CMDA honored Dan and his wife, Miriam, with the Servant of Christ Award. Dan continues to teach others the importance of integrating faith and medicine through his work as Director of the Global Health Training Program at King College in Bristol, TN.
1 Doctor + 1 Advocate = 100s Touched by God by Marc A. Hirsh, MD, and Lynn Eib
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t has been 14 years since I made a decision that ended up transforming my medical practice and impacting an entire community for the kingdom of God. The decision: I hired a patient advocate to offer emotional and spiritual support to my cancer patients and their caregivers. As a Messianic Jewish believer I know a personal relationship with God is the only true answer to all my patients’ deepest needs. But in the first seven years of my solo oncology practice in southcentral Pennsylvania, it was easy to see that there wasn’t enough time in the day for me to adequately address those manifold needs. So in 1996, God prompted me to hire one of my cured patients to be on-site as a patient advocate. It is Lynn Eib’s job to befriend patients and their caregivers, show them the love of Jesus, and hopefully help them draw closer to the Lord during their cancer journey — no matter how far they may have been from Him at the start. I felt pretty confident when hiring Lynn that her presence — and God’s special presence through her — would have a positive impact on my patients and their families, but what has transpired has been far richer and more far-reaching than either of us could have imagined. Lynn’s services are available free to all our patients and their caregivers and to date she has met nearly 2,200 newly diagnosed cancer patients in my practice. Area physicians also are welcome to make referrals and often ask her to stop
by the hospital and chat with a newly diagnosed cancer patient or make an appointment for a distraught patient to talk with her. Every patient who walks through our doors meets Lynn and has the opportunity to address spiritual and emotional concerns such as: “What is the meaning of life?” “Where can I find hope?” and “Why me?” We know of at least 100 of our patients and family members (including two Jewish patients) who have made decisions to follow Jesus or who have rededicated their lives after long years of being away from God. Many of these people in turn have shared the gospel with others, and we have seen many more family members and friends come to faith as the ripple effect continues for years. A great example of this is a patient named Donald, who along with his wife Jackie started attending Lynn’s Cancer Prayer Support Group and then her church (after being away from worship for thirty years). Donald drew very close to God in his last days and after he died, Jackie continued to attend Lynn’s church. She’s rarely missed a Sunday in the years since and three of her four grown children now worship somewhere regularly, while eight of her grandkids, her six great-grandkids, and a handful of nieces and nephews usually attend services with her. An entire family tree has been touched for Messiah. The cancer support group that Lynn started in 1991 has grown into two groups and in 2003 she added a Grief Prayer Support Group for those who have lost a loved one to cancer. Ministering to these grieving people has proved to be invaluable, and many say the group “saved my life.” Twice a year she brings all three groups together with family members and friends for a dessert concert where I entertain with saxophone and keyboard music, interspersed with an inspirational message. At the most recent Christmas Concert we had 125 attend, and God’s Spirit was very evident that night. A few weeks later Lynn was at a funeral for one of her group members and a family member shared that she always would treasure her memory of that Christmas concert
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1 Doctor + 1 Advocate = 100s Touched by God 22
because it was the last special time she had with her sister before she passed away. There are many tangible benefits to me in having a patient advocate, including the fact she saves me time (and therefore money) as she handles emotional/spiritual patient issues, which if ignored would have produced anxiety and medical symptoms I would have had to address. She also provides me with a window to what’s happening in the personal lives of patients — issues that may affect their attitude toward treatment, understanding of it, or compliance with my instructions. My staff and I don’t want to ever lose sight of the fact we are treating people and not simply a diagnosis or a billing code. The positive effect of having a patient advocate in our office even has extended into the local community. Our practice has a reputation of being “different” or “special” because of our emphasis on treating the whole person. We are seeing more and more patients actually choose to come to our practice for treatment because they have heard about what we offer here. When I first hired Lynn, she had no formal medical training or experience in a medical office. Her knowledge of cancer centered mainly on her own experience and anecdotal experiences of those in her cancer support group. But in the intervening years, she has gained an understanding of evidence-based medicine, scientific methods, and the natural progression of cancer. This enables her to be a better patient advocate while integrating the scientific, emotional, spiritual, and economic dimensions of dealing with cancer. Because she understands diagnoses, treatment, and prognoses, she is able to explain things in ways patients can understand and to serve as a liaison to improve the doctor-patient relationship. One other amazing thing that God has done through Lynn’s position is to open up a worldwide cancer ministry for her through her published books. We keep several copies of each of her three books (When God & Cancer Meet, Finding the Light in Cancer’s Shadow, and When God & Grief Meet) in our patient lending library and hun-
T o d a y ’s C h r i s t i a n D o c t o r
dreds of patients have read the encouraging truths that God can be trusted in their difficult journeys. To date we’ve given away about 100 free copies of the He Cares New Testament with Psalms & Proverbs, for which Lynn wrote the inspirational commentary. How gratifying it is to see scores of our patients and their family members carrying the Word of God with them and reading it each day — when most of them admit they never really read the Bible before. I fully recognize that God has done something very special through our practice and would not want to suggest that every physician should do things exactly the way we have in order to try and replicate these results. But I do believe God wants to use every believing physician for His glory, and that partnering with a patient advocate (or navigator, or whatever term you wish) will produce results for the kingdom of God that are far richer and more far-reaching than you ever could have imagined. ✝
Marc Hirsh, MD, is board certified in Medical Oncology and Internal Medicine. He has been in private practice in Hanover, PA, since 1989. Since 1996 he has offered a free service of patient advocacy to address the emotional and spiritual needs of cancer patients and their caregivers. He also recently began offering genetic counseling for some hereditary cancer mutations. Dr. Hirsh is a member of CMDA. He also is a clinical assistant professor of medicine at the Pennsylvania State University College of Medicine, past-president of the Central Pennsylvania Oncology Group, and medical director of the Hanover VNA Hospice.
Lynn Eib is a cancer patient advocate, group facilitator, and longtime colon cancer survivor. She authored When God & Cancer Meet; Finding the Light in Cancer’s Shadow; and, When God & Grief Meet. She has spoken throughout the country on the subject of faith and medicine and presents half-day seminars for cancer patients or grievers and those who minister to them. Her website, www.CancerPatientAdvocate.com, is dedicated to helping people provide emotional and spiritual encouragement to patients and their caregivers, especially those facing cancer. It includes information about patient advocacy, as well as resources for those wishing to start, facilitate, or find a faith-based cancer support group.
1 Doctor + 1 Advocate = 100s Touched by God
How I Try to Touch Each Hurting Person with God’s Great Love Editor’s Note: We asked Mrs. Eib to share three or four principles that guide her as she seeks to minister to patients whom she comes to know through her practice as a patient advocate. First, feel people’s pain (Job 2:11-13). Remember when three of Job’s friends heard of the tragedy he had suffered? They got together and traveled from their homes to comfort and console him. The Bible says that, “When they saw Job from a distance, they scarcely recognized him. Wailing loudly, they tore their robes and threw dust into the air over their heads to show their grief. Then they sat on the ground with him for seven days and nights. No one said a word to Job, for they saw that his suffering was too great for words” (NLT). When I minister to cancer patients and their families, I feel their pain while saying very little. Secondly, be willing to lend strength for people to fight their battle with illness (Exodus 17:8-13).
troubles so that we can comfort others. When they are troubled, we will be able to give them the same comfort God has given us” (NLT). And finally, share gently and respectfully about Messiah, as people want to hear (1 Peter 3:15-16). The Apostle Peter describes this kind of readiness when he says, “Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have. But do this with gentleness and respect, keeping a clear conscience, so that those who speak maliciously against your good behavior in Christ may be ashamed of their slander” (NIV). The bottom line is that as a patient advocate, it’s not about me, but as Colossians 1:19 says, it’s about “depending on Christ’s mighty power that works within me” to touch each hurting person with His great love. ✝ – Lynn Eib
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Remember the Bible account of Joshua and the Israelites fighting the Amalekites? “As long as Moses held up the staff in his hand, the Israelites had the advantage. But whenever he dropped his hand, the Amalekites gained the advantage. Moses’ arms soon became so tired he could no longer hold them up.” So his brother and a friend found a stone for him to sit on. Then they stood on each side of Moses, holding up his hands so they “held steady until sunset” (NLT). As a result, Joshua overwhelmed the Amalekites in battle. I don’t fight people’s battles for them, but I give them a stone to sit on and hold up their weary arms. Thirdly, comfort patients with the comfort I have received from God (2 Corinthians 1:3-5). The Apostle Paul says it best in 2 Corinthians: “All praise to God, the Father of our Lord Jesus Christ. God is our merciful Father and the source of all comfort. He comforts us in all our
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Ethics in Tension: The Christian Physician Sharing His Faith by Drs. Elizabeth K. Hensley and Samuel D. Hensley
[* denotes specific reference to the CMDA Ethics Statement on this subject — see sidebar]
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he role of spirituality is being increasingly recognized as important and clinically significant in health outcomes.* For well over a decade, articles have been appearing in the medical literature supporting the integration of spiritual care as a routine part of the medical encounter. Many medical schools now teach courses on spirituality. JCAHO requires the spiritual assessment of patients in many of the clinical settings that they accredit, such as hospitals, long-term care facilities, and behavioral health facilities. While the acknowledgment of the importance of the spiritual dimension of patient care is encouraging, it does raise questions regarding ethical issues for physicians. In a pluralistic society it is not surprising that there are differing opinions about the role of the physician in addressing patient spirituality. As Christian physicians, we may feel conflicted and unclear about our roles and responsibilities. We may sense an ethical tension between our identity as a Christ follower, compelled by the gospel and our physician identity, bound by societal and professional expectations. We do not view our patients through the lens of scientific reductionism. Rather we see them as unique and complex beings with spiritual, emotional, moral, and physical needs throughout life. Acknowledgment of this is not isolated to Christian belief. Many in the medical profession representing diverse religious and philosophical positions are embracing the concept of holistic patient care. Much of this stems from the recognition that illness brings suffering into the lives of our patients, and this suffering is not limited to the physical body. Any physical compromise can impact the
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Respectful, noncoercive, and informed dialogue regarding spiritual matters communicates a true concern for the dignity and wholeness of our patients.
patient and their family in innumerable ways, causing a fracturing of everything that has brought meaning and purpose to their lives. Not surprisingly, studies have shown that a large percentage of patients feel their physicians should acknowledge and inquire about their religious beliefs. Typically only a very small percentage of patients find this sort of inquiry problematic. Many physicians are legitimately concerned about how to ethically proceed with the integration of spiritual care into their clinical practices or even how to respond to patient requests for spiritual help. As Christians we view our relationship with our patients as covenantal, always seeking their good in all aspects of their lives.* In years past, most physician-patient relationships were based more in the ideals of covenants and oaths. The fiduciary nature of the relationship required the physician to always act in the best interest of the patient. The nature of the relationship was generally one of mutual trust, respect, and responsibility. This naturally allowed for more spontaneous dialogue regarding spiritual matters. Many changes in both the culture and in medicine have occurred over the last several decades that have altered the nature of this relationship. Many feel that some physicians acted in a paternalistic manner making decisions independent of their patients, thus contributing to the erosion of this trust relationship. There has also been an increasing emphasis on patient autonomy and self-determination in medical decision making. Lastly, through the increasing emphasis on quantifiable performance, disease management protocols, and practice guidelines the medical encounter has been significantly impacted, approaching the factory or business model in severe instances.
Ethics in Tension: The Christian Physician Sharing His Faith
This is not to say that each of these changes has not been supported by valid concerns or observations and are not without merit. Indeed, it is prudent for us to consider the benefits these changes have provided that enable us to offer better and more ethical care to our patients. As Christians we affirm the dignity of all human beings and respect their rights to make independent and well-informed decisions. It would be abhorrent to use coercion or ignore our patients’ core beliefs and desires. We also believe that we should be excellent in our work for the glory of God and the good of our patients. We embrace advances in medicine that enhance our ability to offer quality care to our patients. Perhaps as Christians where we differ is in the realization that we are by nature in relationship with our Lord and with our fellow man. We are “our brother’s keeper” and therefore we approach all these issues through a unique paradigm. Our practices, like our lives, cannot be compartmentalized, but are integrated into the new life that we live in Christ. Likewise, our earnest desire and hope is that our patients live and flourish in every aspect of their lives through the restoration and hope offered in the gospel. In the CMDA ethics position statement on sharing faith in our practice it is stated, “our faith should be implicit in our actions.”* We must remember that first and foremost our patients come to us for good, quality medical care. In CMDA’s “Saline Solution,” William Peel reminds us that it is not merely competence but character, integrity, and compassion that make us agents of positive spiritual influence. We would be very ineffective ministers of the gospel if there were incongruence between our words and our actions. We know that we do not convert anyone. The Holy Spirit is the power at work in revealing the light of the gospel.* For this reason, we acknowledge the role of
prayer, faith in God’s sovereignty, and the discernment provided by the Holy Spirit to know when and how it is appropriate to share our faith. Our goal is always to express the love of God to our patients and to serve them, knowing that God is always at work. We should never see our patients as our personal salvation projects. Patients are very discerning and may feel a lack of real compassion and respect from the physician who appears to be merely proselytizing. How well we all know that we are given both the privilege and responsibility of walking with our patients through many difficult and perplexing situations. It is in times like these that patients will often open up to us with regards to spiritual issues. When our patients indicate a desire for spiritual help or for prayer, we should accept the opportunity to offer what they need.* It is also in these times that we may feel prompted to share with our patients our own faith. This should always be done with permission from the patient, recognizing their vulnerability, especially in those from other cultures or in those with diminished decision-making capacity.* We should be open, authentic, and thoughtful while being attentive to the stories and messages our patients are providing. We should be careful that we respond to patient’s beliefs, questions, and struggles in ways that are not condescending or judgmental. We are all comfortable (or should be) in applying these ethical guidelines with patients when dealing with other intimate issues such as sexuality or lifestyle choices. It is very reasonable to assume that equally ethical dialogue can take place in spiritual matters. For many physicians, the increasing emphasis on attending to patients’ spiritual needs has made it easier to initiate these conversations with patients long before critical situations arise. There are many resources now available to help physicians take
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a spiritual history on their patients and incorporate it into the medical record. Once again, this should always be done with the patient’s permission and in a non-threatening or intrusive way. Many physicians will not be comfortable using a prepared form or methodology to gain insight into the spiritual lives of their patients. Each physician, acknowledging their unique equipping, can find ways to incorporate ethical, caring communication with their patients with regards to their spiritual well-being. Many find that this can be a natural component of the social history. Others may find they can develop their own style of caring inquiry that will seem more natural and authentic both to them and their patients. We remember one highly regarded orthopedic sur-
Notes from the CMDA Ethics Statement: Sharing Faith in Practice* • We seek the well-being of our patients in our covenantal relationship with them. • Clinical studies demonstrate the importance of spiritual health in physical well-being. • Conversion is the Holy Spirit’s work, not ours. • Our faith should be implicit in our actions. • We accept invitations from our patients to pray with them at their request. • If prompted to share our faith with our patients, we do so with their permission for such an interaction, recognizing their vulnerability. We are especially sensitive to those who are of another culture or when caring for patients with diminished decision-making capacity. • We respect our patients and their beliefs, and expect that our faith should be respected by the institutions in which we work according to our right to freedom of religion and speech.
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geon who was known to be a man of deep faith and few words. His common verbal entry into the hearts of his patients was simply to ask them, “How is your world?“ It is not unusual for people of faith to choose to openly display their beliefs through the office environment. Many do this using artwork, attire, literature, videos, or a variety of other means. Although there are a few who have commented negatively on this sort of display, most feel that if this is done in a sensitive, tasteful, and respectful manner it is entirely appropriate. It also has the added benefit of making patients aware upfront of their physician’s faith perspective. Generally, clinics and medical ministries that are directly linked to their faith alliances are free to speak and minister openly according to their religious profession. We are certainly entering a new era in medicine as we deal with the issues of right of conscience. Some physicians may find that their particular work environments have policies that prohibit the sharing of their faith. Physicians that are applying thoughtful and ethical means to caring for their patients’ spiritual needs are acting within their rights to freedom of speech and religion.* In the classic sense the concept of tolerance implies that there are differences to be tolerated. Respectful, noncoercive, and informed dialogue regarding spiritual matters communicates a true concern for the dignity and wholeness of all of our patients. It demonstrates what true tolerance can be in a free society. It is important that each physician remember they do not solely bear the burden for their patients’ spiritual health. To feel that way would be to put us in the place of God — a job that none of us is qualified for. We are given the unique privilege of entering into a sacred part of our patients’ lives through each medical encounter. It is of necessity that we remain humble and truly grateful to be a part of their journey. We must realize our limitations and remember that we are a part of a greater body. The physician should know the spiritual resources of the community and of the local chaplain services where he practices. Often difficult theological questions arise that are beyond the expertise of the physician. In those instances, patients are often better helped by others who are excellently prepared to handle difficult issues. It also should be an encouragement to us to continually deepen our understanding of spiritual issues and to grow in the wisdom and knowledge of such things. We should work to develop ways to articulate our faith through an ethic of love and caring. Let us always remember that the apostle Peter said that, “We should always be prepared to give a reason for the hope that is within us.“ ✝
Elizabeth Hensley, MD, received her medical degree from The University of Mississippi. Her work experience has included private clinical practice in pediatrics, public health, and corporate administrative work. She has served on the CMDA National Ethics Committee and works on the local level teaching and mentoring students in the CMDA chapter in Jackson, MS. She is also a Fellow with the Center for Bioethics and Human Dignity in Deerfield, IL. Along with her husband, Sam, she has taught and coordinated an elective course in bioethics for senior medical students at the University of Mississippi Medical Center. Annotated Bibliography “The Saline Solution” - A CMDA resource, provides enhanced understanding of the issues presented in this article. It is a very helpful tool for any physician wishing to learn more about sharing Christ in their practice and we would highly recommend it.
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Walt Larimore, MD, writes a helpful article addressing many of the issues in The American Family Physician, “Providing Basic Spiritual Care for Patients: Should It Be the Exclusive Domain of Pastoral Professionals?” See: http://www.aafp.org/afp/2001/0101/p36.html. Al Weir, MD, provides beneficial and compassionate ideas on the integration of faith and medicine in his article in The Community Oncologist, “Where faith and medicine meet.” See: http://www.communityoncology.net/journal/articles/ 0306372.pdf. Farr A. Curlin, MD, Daniel E. Hall, MD, MDiv, Journal of General Internal Medicine (2005: 20): 370-374. “Strangers or Friends? A Proposal for a New Spirituality-In-Medicine Ethic.” This is an extremely insightful article proposing that physicians can “engage patients regarding religious concerns guided by an ethic of moral friendship that seeks the patient’s good through wisdom, candor, and respect.” Highly recommended for the physician seeking to understand where some of the dissenting arguments have been raised. They briefly discuss, as have other authors, that “moral neutrality is not possible.” We agree and feel that refusal to be authentic and open with patients regarding spiritual matters can convey a “moral and ethical message” that can be antithetical to the goals of patient care and to both our personal and professional ethics. The professional boundaries that many commentators would set are both artificial and disingenuous. Spiritual and religious preferences inform most decisions patients are faced with and the thoughtful physician should be able to discern and communicate ethically and sensitively with his patients as needed.
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Samuel Hensley, MD, serves as Bioethics Consultant to Mississippi Baptist Medical Center. He is on the Board of Directors of Matthew 25:40 Ministries, an outreach to the elderly in Chicago. He is also a member of the Executive Committee of the local campus-based chapter of CMDA and has served on the CMDA National Ethics Commission. Dr. Hensley received his MD from West Virginia University in 1979, completed a Residency in Anatomic and Clinical Pathology in 1983 at Wilford Hall in San Antonio, and a Fellowship in Neuropathology at the Armed Forces Institute of Pathology in 1985. He received a Master’s Degree in Christian Thought and Ethics from Trinity Evangelical Divinity School, where he now serves as a Fellow with the Center for Bioethics and Human Dignity in Deerfield, IL.
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Editor’s Note: This article is the fourth of six in a series focused on “Professionalism in Peril.”
PROFESSIONALISM IN PERIL Part 4 — Character Counts by Gene Rudd, MD
“In everything set them an example by doing what is good . . .” (Titus 2:7, NIV).
P
reviously in this series we discussed the origins of professionalism. The construct is rooted in a person professing a moral obligation to those he or she serves. However, that obligation is no more reliable than the quality of character of the individual making the declaration. Hence, professionalism hinges on the character of professionals. “A man’s word is his bond.” “A handshake is as good as a contract.” These quotes from my father reflected a time past. Even when my dad spoke it was with sadness at seeing its loss. While these “good old days” included exceptions, there existed a social expectation that most individuals were of such a character that they would honor their commitments. Many today still reflect this code, but few would argue that they reflect our culture in general. Nevertheless, even as these social mores changed, expectations lingered in medicine. By and large, patients continue to suppose doctors to be persons of integrity.
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Unfortunately, the daily news too often highlights colleagues and healthcare systems that are not. Opinion polls indicate that the pedestal upon which doctors have been placed has shortened, and in some cases, vanished. The United States Air Force Academy defines character as “the sum of qualities of moral excellence that stimulate a person to do the right thing, which is manifest through right and proper actions despite internal and external pressures to the contrary.” Another simpler, practical definition of character is what you do when no one is watching. Since God is always watching, only He knows our true character. Others know only our reputation. With the aid of real life stories and television medical dramas that commonly portray doctors with flawed character, our reputation is growing tarnished. Medicine has long understood the necessity for character among caregivers. This is referenced or implied in various professional codes. The code most foundational to Western healthcare is the Hippocratic Oath. The principles to be ascribed by those taking the Oath are beautifully explicated by Leon Kass (Toward a More Natural Science, 1985). I doubt anyone would challenge the notion that the intimacy required and the power differential inherent in healthcare can only be rightly conducted by persons of character. Just ask anyone if they would choose to be attended by someone bright, technically competent, but flawed in character. For professionalism to be maintained in healthcare, it must be practiced by persons of character. How well have we done? And how do we ensure this expectation and practice continues, avoiding a peril to professionalism? William Bennett (The Book of Virtues, 1996) and others argue well that character is more “caught” than “taught.” In essence, the virtues we possess are largely instilled at formative times in our lives, beginning quite early. While professional decorum can be taught in medical school, the moral soil for this to take root must have been cultivated at an earlier age. Even in the process of “professionalization” in
Professionalism in Peril
medical and dental schools, character modifications are more greatly affected via implicit training (rounds, call room, lunch room, bedside, etc.) than via explicit training (the classroom). As was true of character development in earlier years, even at the age of formal professional education, role models are key. Who are these role models in today’s culture? Do they have the “right stuff” to guide the next generation of professionals? Some do, but, sadly, not all. In a survey reported in the journal Nature (Vol. 435, 9 June 2005), depending on the question asked, up to 27 percent of scientific researchers report inappropriate investigational behavior. Stories of fraud in medical literature are likewise far too common. When professional role models fail to live up to professional standards, it has the same result as when parents try to teach their teenagers not to speed while they themselves use a radar detector. The professional community, while not broadly confessing our failures in this arena, has, nevertheless, attempted to address the problem. For more than a decade there has been an outpouring of courses and statements on professionalism, with a primary focus on character and conduct. While I do not disregard these efforts, I simply ask, “Is it enough?” Sitting in a garage does not make you a car. You must have gone through an automobile assembly plant to possess the features and functions of a car. Likewise, sitting through courses or reading statements on professionalism will not transform someone’s character. There must be a changed heart and mind. Warren Kinghorn and colleagues addressed this question in the January 2007 edition of Academic Medicine. Of interest, the article cites others as saying that the virtues are inherent and self-evident in the practice of medicine. If so, why the plethora of publications in recent years? It seems to me that we are trying to prescribe a medicine without admitting there is a disease. While consistent with the knowledge that moral development must occur early, most disappointing was Kinghorn’s finding that there is no evidence that any of these statements of professionalism have made any difference in the practice of medicine (in behavior or attitude). Perhaps the most widely circulated statement is the Physician Charter published in 2002. It cites three fundamental principles: primacy of patient welfare, autonomy, and social justice. It adds a list of professional responsibilities, e.g., competence, honesty, and confidentiality. Of particular note was the veiled warning in the introduction in the Annuals of Internal Medicine: our “challenge will be to live by [it].” Knowledge is of little value if it does not change who you are and what you do. Or as Scripture teaches, “Do not merely listen to the word, and so deceive yourselves. Do what it says” (James 1:22, NIV).
Kinghorn makes a compelling case that virtues and values are not likely part of someone’s life unless they were developed in a moral community. A person must experience a tradition of virtue at a formative time in life for proper character development. With this understanding, he concludes that in order to have physicians of noble character and virtuous behavior, we should screen for these characteristics in those who seek admission to professional school. If applicants have not already been shaped by immersion in a moral culture, admission should be denied! The same day I wrote the above paragraph I read an opinion piece by bioethicist Jacob Appel in which he advocates for a pro-choice litmus test for applicants to obstetrical training. He concludes that is the only way to ensure we can have enough abortionists. The irony! When doing a brief stint in the Philippines, my attention was caught by an automobile body shop. For a remarkably low fee, if you could bring them a suitable chassis and drive train, they would fabricate a Rolls Royce body around it. At least from a distance, it looked like a Rolls Royce! Up close, the rough edges and misfits were evident. I suspect that if you were to drive the concoction down a bumpy road, the fenders would fall off. The point: If you really want a Rolls Royce, it needs to be built in the Rolls Royce assembly plant. Yes, change in character can occur later in life, even after medical or dental school, but it is far too rare. The film, The Doctor, produced in 1991, starred William Hurt as the doctor who was technically competent and financially successful. However, there was a problem: His relationship with patients was sterile, distant, and uncaring. Other doctors in the script were portrayed similarly. Young doctors were being trained to be just like them. (Sadly, none of the reviews challenged this stereotype. It was accepted to be true.) It was not until the protagonist developed cancer and became the patient that his out-
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look changed. In writing for the President’s Council on Bioethics, the noted bioethicist, Edmund Pellegrino, points out that we cannot adequately view our responsibility to professionalism unless we can see healthcare from the gurney. Though I do not watch them, I understand that most television medical dramas attempt to present stark reality as they portray healthcare and healthcare professionals. The results are all too often characters of flawed character. While viewers’ basal interests are likely peaked by these flaws, I do not hear anyone protesting that this is a fabrication. While I am sure this is not who we wish to be, it seems to be who we have become. Here are some clues: • Last year the NEJM carried a perspective article bemoaning the loss of etiquette in medicine (“Etiquette-Based Medicine,” NEJM: 358, 19; May 8, 2008). We don’t even knock before entering an exam room or hospital room. • We have lost the virtue of saying “I’m sorry.” We have been taught by malpractice attorneys and those who teach risk reduction that we are to deny or be silent about our mistakes. Numerous articles in recent years point out how shamefully late we are in recognizing the futility of this strategy and the harm done to our sacred relationship with patients. • Just months ago the Joint Commission issued a statement that healthcare organizations should sanction doctors who bully staff. The motivation for this position was not civility or professional decorum; it is a quality of care concern. Bullies are less receptive to having errors pointed out. That leads to less corrective actions and poorer outcomes. • And more troubling: In a national survey of 10,000 family practitioners, internists, obstetricians/ gynecologists, and surgeons (there were 1,891 responses). Nine percent acknowledged sexual contact with one or more of their patients. See: http://www.thedoctors.com/KnowledgeCenter/ PatientSafety/articles/CON_ID_000320. No wonder we have lost trust. We have lost our social graces. We can’t even knock or seek permission before entering a room. We have become bullies. And many of us are involved in sexual misconduct. Though not true of all professionals, these things are true of too many. Statements on professionalism are not enough. As those who make a profession — a moral obligation to those we serve — we must commit to live lives in such a way that our patients will never wonder if this new stereotype of a flawed doctor applies to us.
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Bill Peel tells the story of a physician friend who was making rounds when he discovered a serious nursing error had been made. He quietly asked to speak with the nurse in private. Not knowing that they were being overheard, he tactfully pointed out the error and the remedy. He finished by adding appropriate encouragement. The colleague who overheard the conversation came to him afterward and said in effect, “Jim, I’m not a Christian, but if you pastored a church, I would attend.” Most readers of this article are past the stage in life when moral development most easily occurs — when character is shaped by our families, cultures, and traditions. And most of us, if we are honest, will admit there are areas of our character in need of improvement. So what remedy do we have? Or more apropos, what do we have to do to be more like Christ? First, we must recognize our limits. Consistently being like Christ is not difficult; it is impossible! Thankfully, we have a loving, gracious, and merciful Father. Since our failures come as no surprise to Him, He has provided a way of forgiveness. With our acceptance by faith, He covers us in the righteousness of His Son. As we continue in His forgiveness, He then wants us transformed into the likeness of Christ. Jesus asked us to believe one thing — in Him and the One Who sent Him (John 14:1). Then, for those who believe, Jesus’ teachings outline what we must do to continue in a right relationship with God and others (e.g., Sermon on the Mount). It is clear that the life acceptable to God is rooted in obedience (Matthew 7:24-27, John 14:23, Hebrews 5:9). Our surrender to His commands allows the Holy Spirit to shape our character. Character that counts, that is fit to sustain our moral obligation (profession) as physicians and dentists, can be found in a life that has learned to trust God and obey His commandments (Matthew 19:17). ✝
Gene Rudd, MD, co-author of Practice by the Book, serves as Senior Vice President of the Christian Medical & Dental Associations. A specialist in Obstetrics/Gynecology, Dr. Rudd has experience in maternal-fetal, medical education, and rural healthcare. He has garnered numerous awards including the Gorgas Medal. While working with World Medical Mission, he established the Christian Medical Mission of Russia, directed the rehabilitation of the Central Hospital in Kigali, Rwanda, and served in Belarus, Bosnia, and Kazakhstan.
This is What I Worship by Phillip L. Aday, DDS
A
fter a thirteen-hour flight and an overnight in Bejing, followed by a thirty-one hour train ride, I was ready to begin seeing patients! Our GHO team had brought all the supplies and equipment necessary to provide restorative dentistry, and after setting up the dental treatment area on the third floor of a hospital in inner Mongolia, I was ready to provide some restorative care for patients . . . but my portable dental delivery unit had “issues” with the local electric current. The unit was correctly configured to run off of the 220 volts being supplied at the wall plug, but my compressor would run for fifteen seconds then shut down, refusing to restart for twenty to thirty minutes. One of the mottos of GHO teams is “flexibility.” Since I could not depend on my portable restorative unit to keep running, I transitioned to providing extractions along with Dr. Sam Molind, the GHO Director who was leading this team. While I was disappointed in not being able to provide restorative care, an abundance of patients needed extractions of non-restorable teeth. My translator, Bonnie,* and I quickly fell into a routine of seating a patient, determining what tooth or in many cases which teeth were non-restorable and needed to be extracted. After administering local anesthesia, I would look across the patient to Bonnie and ask if it was “ok” to share with the patient. If Bonnie gave the ok, while the patient was getting numb, she and I would share the gospel. To my pleasant surprise, we had a great deal of freedom to share individually with our patients. Many of our patients were receptive, others politely listened, but were not at the point where they were ready to make a commitment. I will always remember one particular patient, Julie.* After seating Julie and determining which tooth was her chief complaint, Bonnie and I shared with her about Jesus. Julie immediately reached into the pocket of her jeans and pulled out a jade Buddha and said, “This is what I worship.” At that point I felt that this woman was not going to be responsive to the gospel. I was ready to wait for the anesthetic to take effect and proceed with her treatment . . . but Bonnie had something else in mind. Without my prompting and in her native tongue, Bonnie began visiting with Julie. Bonnie was not badgering Julie, but she obviously was feeling the leading of the Holy Spirit to continue sharing with her. In my short time in-country I had learned a few Chinese words and I
Often, the medical/dental care GHO provides is a godsend to those in need
began frequently hearing Bonnie use the words for “love” and “Jesus.” After a few minutes Julie turned to me and through Bonnie said, “I could worship Jesus . . . along with Buddha.” Knowing a little bit about Eastern religions, I was not surprised at her willingness to “add another god” alongside her worship of Buddha. I gently explained to her that the one true God would not accept her worship of other gods. I explained as best as I could through Bonnie that if we were able to travel, we could visit Buddha’s grave, where he remains buried. We could also visit Jesus’ tomb and see that His tomb is empty because He rose from the dead after conquering sin and death. I was again ready to move on and provide the dental treatment necessary, but Bonnie and the Holy Spirit were not through. Bonnie continued talking with Julie, and then, a few minutes later, Julie said she would like to pray to receive Christ. Was I skeptical. The last thing I wanted was for this lady to have been badgered into doing something just to please us. However, I have learned over the years I tend to think it is more difficult to come to faith in Christ than it really is. So with Bonnie’s help I led this willing patient through a prayer of confession and acceptance of Jesus as her Lord and Savior. Julie’s response removed all doubt that her decision was genuine. Immediately after saying, “Amen,” she reached into her pocket and once again brought out the image of Buddha, only this time her words were, “Now what do I do with this?” My precious new sister in Christ no longer wanted to carry a jade image of Buddha, but instead
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association of churches, and now also with you. I still have the jade Buddha, which reminds me daily of the power in the name of Jesus. It also reminds me of the need for flexibility on GHO teams. I had planned on doing restorative dentistry, but God had another kind of restoration planned. My restorations would have eventually failed, but the restorative power of God through Jesus Christ as experienced by Julie will never fail. What a joy and privilege it was for me to be God’s partner in that process. ✝ *Name disguised to protect the person’s privacy Sometimes it seemed that the whole town was in need of our help
wanted to know how to get rid of it! She had gone from worshiping a jade image of a false god to a realization that the one true God had set her free through her new found faith in Jesus Christ. “You could smash the jade Buddha,” I said, “to signify your triumph in Christ, or, if you would allow me, I would be honored to take that image back to the United States and use it as a testimony of the power of Jesus over false gods. When my new sister in Christ placed the jade Buddha in my hand, I felt an awesome sense of responsibility to share her testimony. Since returning stateside, I have been able to share her testimony with my local
Phillip L. Aday, DDS, has been a member of CMDA since his dental school days. He began participating in dental mission trips while in dental school. After several tours with the US Army, Dr. Aday joined a private practice in Lawton, Oklahoma, which he eventually purchased. He and his wife and two sons have gone on numerous GHO mission trips as a family. One of his goals is to participate in a dental mission to every continent. Thus far, the count is four continents, but he is not sure if he will make it to Antarctica.
CLASSIFIEDS Miscellaneous Clinical Tropical Medicine and Traveler’s Health – ASTMH accredited. June 15-August 6, 2010. Sponsored by West Virginia University School of Medicine Office of CE and the Global Health Program. Contact Nancy Sanders at: 304-293-5916, or nsanders@hsc.wvu.edu.
Interventional Pain Management – Westlake (Cleveland), Ohio. Seeking a BE/BC Fellowship trained Christian physician to replace a retiring physician. A private practice with unique compensation. M-F 9 am – 5:30 pm. For more information, go to www.clearwaterpainclinic.com. Position available summer 2011. Contact Administrator Sun-Hee at: 440-899-8622 or 44clearwater77@adelphia.net.
Overseas Missions Volunteer Christian Dentist needed to work with Kenyan dentist from July, 2010 through April, 2011 at Tenwek Mission Hospital. Applicants for part of this 10-month period will be considered. Contact Medical Superintendent at: Russ.White@WGM.org. Primary Care Physician (Internal or Family Medicine) to serve at Subbamma Christian Hospital, India (www.hope-for-people.org). Housing and all meals (international standards) and round trip airfare paid. Minimum one year commitment. For more information contact Richard Yook, MD at: yookmd@yahoo.com or 818-993-5410.
Positions Open
Internal Medicine/Family Practice – Wellmont Health System is seeking an IM/FP for Wise Medical Group located in Norton, Virginia. Employment position with generous salary, sign-on, relocation, 1:7 call, and teaching opportunities. Contact Jason Freeman at: 423-230-8270 or Jason.Freeman@Wellmont.org.
Psychiatrist – Fast growing psychiatric clinic in Plano, TX seeking Christian psychiatrist. Clinic offers brain SPECT Imaging and full service outpatient services. Competitive compensation and benefits. E-mail resume to: sall@clementsclinic.com, or fax to: 972-781-0203.
Otolaryngologist – Beautiful North Cascades area of Washington State. Located between Seattle, Washington and Vancouver, B.C. The area offers quick access to the San Juan Islands or the Cascade Mountains for hiking, fishing, kayaking, to name just a few of the exceptional outdoor recreational opportunities available. An excellent partnership opportunity to join a well established five-physician practice in Washington State. We are seeking a board eligible or board certified physician. Please contact: Human Resources Department, Brooke Herzberg, Director, Cascade Medical Group, 360-336-2178, brookeh@cascademedicalgroup.com.
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Dental – Associate for thriving general and prosthodontic dental practice. Christian dentists, in-house lab, no insur. Great experienced staff, area needs dentists. 2 1/2 hrs to NYC, safe, beautiful, stable area, low housing costs. Long established practice with excellent reputation. Partnership opportunities. Contact: jboyd13168@gmail.com.
Orthopedic – Well-established practice of three orthopedists and one podiatrist committed to providing care with compassion as well as excellence. Time off for short-term missions. Would like to talk with general and subspecialty orthopedists about the possibility of joining us in practice. On-site surgery center; local hospital within walking distance. Located in a family-oriented city where many recreational and cultural activities are available. Less than a 10-minute commute from any area of the city. Low malpractice rates and cost of living. Vacation at the mountains and the beach; live here and enjoy all four seasons. Please contact our Medical Director, Dr. Chris Wilkinson at: 308-627-4664 or cwilkinson@kearneyortho.com. Our clinic manager, Vicki Aten, can be reached at: 308-865-2512 or vaten@kearneyortho.com.
Pediatrician – Montgomery, AL. Seeking a BC/BE pediatrician to join a group of 4 Christian pediatricians. Competitive salary and benefits; call 1:4. High priority on family life. Position available July 2010. Please contact Bonita Lancaster at: 866-507-3385, or e-mail your CV to blancaster@baptistfirst.org.
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