volume 46 no. 3 fall 2015
TODAY’S
CHRISTIAN DOCTOR The Journal of the Christian Medical & Dental Associations
IN THIS ISSUE
We’ve Come a Long Way, Baby(ies)! Fighting back against human trafficking in your local community
A palliative care physician explores the dangers of physicianassisted suicide
Learn how to identify religious struggles and their impact on your patients’ spiritual health
CMDA
GROUP
MEMBERSHIP
Southwestern Medical Clinic; CMDA Group Members
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DESIGNED WITH YOU IN MIND If your practice has five or more current members or qualifying individuals who want to be a member, your practice qualifies for GROUP MEMBERSHIP
A qualifying staff member is a degreed healthcare professional, associate health, resident or graduate practicing doctor Everyone has the same renewal date A single invoice for multiple memberships is mailed to one contact person at your practice, office or hospital
Contact CMDA’s Member Services www.joincmda.org memberservices@cmda.org 888-230-2637
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Courage to Stand Firm Let me commence my first letter as President of CMDA by reminiscing about my past: I was raised in Northern Indiana by a family that allowed me to roam the streets. I was often in trouble with the police for minor infractions. My parents were very poor and it was commonplace for me to meander along the alleys and check out the trash cans. In high school, I was called “swamp rat” because of my long, greasy hair and black leather jacket.
Likewise, as Aslan is symbolic of Christ, the apostle Peter writes of Christ, “…now that you have tasted that the Lord is good… declare the praises of him who called you out of darkness into his wonderful light” (1Peter 2:3,9, NIV 2011).
from the CMDA
When I was 13 years old, I found myself in a church service where all my buddies responded to the invitation to “go forward.” I followed along for interest’s sake and was led through the plan of salvation, which I accepted. At the age of 17, I questioned my relationship with Jesus and gave Him my life for whatever He would choose, confessing my sins and my need for a How does this apply to you and to me? God Savior to save me. has called us into the practice of healthcare to be witnesses of Christ’s love to our patients and to When I surrendered my life to Christ, little our culture. No matter the personal cost, that is did I realize that He would take me to medi- the charge. cal school and then on to the Central African Republic as a healthcare missionary. I served, As you read the following articles on emwith my wife Martha, in a small rural hospi- bryo donation, human trafficking, spiritual astal in the Central African Republic from 1985 sessments in clinical care, short-term missions to 1987, and again from 1992 to 1994. Since and physician-assisted suicide, you will notice 1996, I have led several dozen medical teams the passion of the authors. They are each conto Niger, C.A.R., Chad, Vietnam, Romania and vinced of God’s calling in their lives and to the Cambodia while working in private practice as witnesses they are to bear to our world. an OB/Gyn. Edmund Burke said, “All that is necessary for When God calls and we respond by saying, “I the triumph of evil is that good men do nothwill follow wherever you lead,” He might just ing.”2 Pray that we will have the courage to pretake you to Africa (as He did me) or some oth- sent the truth and stand firm on the principles of er place you would rather not go! In addition, the Word of God. God does not promise our safety as we obey.
James Hines, MD
president
Dietrich Bonhoeffer stands as an example of the potential cost of following Christ. Bonhoeffer was a German Lutheran pastor and antiNazi dissident who was known for his staunch resistance to the Nazi dictatorship. He stood in opposition to Hitler’s euthanasia program and genocidal persecution of the Jews.1 The decision to follow Christ cost Bonhoeffer his life as he was led naked into the execution yard and hung.
In The Lion, the Witch and the Wardrobe, C.S Lewis writes of Aslan, the great lion who is the Bibliography rightful King of Narnia, “‘Safe?’ said Mr. Beaver, 1 Rasmussen, L. (2005). Dietrich Bonhoeffer: Reality And Resistance. p. 130. ‘don’t you hear what Mrs. Beaver tells you? Who 2 Burke, E. (1757). A Philosophical Inquiry into the Origin of said anything about safe? ‘Course he isn’t safe. Our Ideas of the Sublime and Beautiful. London: Printed for But he’s good. He’s the King, I tell you.’” R. and J. Dodsley in Pall-mall.
INTER ACTIVE Visit www.youtube.com/cmdavideos to learn more about CMDA's new President James Hines, MD.
Christian Medical & Dental Associations www.cmda.org 3
contents Today’s Christian Doctor
I VOLUME 46, NO. 3 I Fall 2015
The Christian Medical & Dental Associations ®— Changing Hearts in Healthcare . . . since 1931.
5 Transformations
are, Not Killing: The Most 22 CExcellent Way
STORY 12 COVER We’ve Come a Long Way,
by Margaret Cottle, MD, CCFP A palliative care physician
explores the dangers of physician-assisted suicide
Baby(ies)!
by Jeffrey Keenan, MD
A retrospective on the National Embryo Donation Center
Trafficking: What 18 HCanuman I Do About It?
by Allen Pelletier, MD; Clydette Powell, MD, MPH; and Gloria Halverson, MD Outlining ways you can get involved in the fight against human trafficking
piritual Assessment in 26 SClinical Care – Part 2: The
LORD’s LAP
by Walt Larimore, MD
How to involve religious struggle into spiritual health
30 Lessons Learned
by Greg “Griff” Griffin, DMD
Short-term missions changed this physician’s perspective on providing healthcare to the needy
34 Classifieds REGIONAL MINISTRIES
Connecting you with other Christ-followers to help better motivate, equip, disciple and serve within your community
INTER ACTIVE Visit www.cmda.org/ classifieds to find more online classifieds.
Western Region Michael J. McLaughlin, MDiv P.O. Box 2169 Clackamas, OR 97015-2169 Office: 503-522-1950 west@cmda.org
Northeast Region Scott Boyles, MDiv Midwest Region P.O. Box 7500 Allan J. Harmer, ThM Bristol, TN 37621 9595 Whitley Dr. Suite 200 Office: 423-844-1092 Indianapolis, IN 46240-1308 scott.boyles@cmda.org Office: 317-566-9040 cmdamw@cmda.org Southern Region William D. Gunnels, MDiv 106 Fern Dr. Covington, LA 70433 Office: 985-502-7490 south@cmda.org
Interested in getting involved? Contact your regional director today!
transformations
TODAY’S CHRISTIAN DOCTOR®
EDITOR Mandi Mooney EDITORIAL COMMITTEE Gregg Albers, MD John Crouch, MD Autumn Dawn Galbreath, MD Curtis E. Harris, MD, JD Van Haywood, DMD Rebecca Klint-Townsend, MD Robert D. Orr, MD Debby Read, RN VP FOR COMMUNICATIONS Margie Shealy AD SALES Margie Shealy 423-844-1000 DESIGN Ahaa! Design + Production PRINTING Pulp CMDA is a member of the Evangelical Council for Financial Accountability (ECFA). TODAY’S CHRISTIAN DOCTOR®, registered with the U.S. Patent and Trademark Office. ISSN 0009-546X, Fall 2015, Volume XLVI, No. 3. 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© 2015, 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. Postmaster: Send address changes to: Christian Medical & Dental Associations, P.O. Box 7500, Bristol, TN 37621-7500. Undesignated Scripture references are taken from the Holy Bible, New International Version®, Copyright© 1973, 1978, 1984, Biblica. Used by permission of Zondervan. All rights reserved. Scripture references marked (KJV) are taken from the King James Version. Scripture references marked (MSG) are taken from The Message. Copyright© 1993, 1994, 1995, 1996, 2000, 2001, 2002. Used by permission of NavPress Publishing Group. Scripture references marked (NASB) are taken from the New American Standard Bible®, Copyright© 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation. Used by permission. Scripture references marked (NIV 2011) are taken from the Holy Bible, New International Version®, NIV® Copyright© 1973, 1978, 1984, 2011 by Biblica, Inc.™ Used by permission. All rights reserved worldwide. Scripture references marked (NKJV) are taken from the New King James Version. Copyright© 1982 by Thomas Nelson, Inc. Used by permission. All rights reserved. Other versions 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, 888-230-2637; Fax: 423-844-1005; Email: memberservices@cmda.org; Website: http://www.joincmda.org. If you are interested in submitting articles to be considered for publication, visit www.cmda.org/publications for submission guidelines and details. Articles and letters published represent the opinions of the authors and do not necessarily reflect the official policy of the Christian Medical & Dental Associations. Acceptance of paid advertising from any source does not necessarily imply the endorsement of a particular program, product or service by CMDA. Any technical information, advice or instruction provided in this publication is for the benefit of our readers, without any guarantee with respect to results they may experience with regard to the same. Implementation of the same is the decision of the reader and at his or her own risk. CMDA cannot be responsible for any untoward results experienced as a result of following or attempting to follow said information, advice or instruction.
New Ethics Statement During the 2015 CMDA National Convention held in Ridgecrest, North Carolina earlier this spring, the Board of Trustees and House of Representatives unanimously approved a new ethics statement on human enhancement. The purpose of this statement is to examine whether or not human re-engineering through technology is: •A cceptable within our place as created beings charged with stewardship of our lives before our Creator God, • E thical within the historical norms of medical ethics, and •P rudent and just within the context of limited medical resources in a world in which suffering due to poverty and absence or profound deficiency of even simple life-saving technology is the reality for over one-third of humanity (according to World Health Organization data).
INTER ACTIVE Visit www.cmda.org/ethics for more information about CMDA’s Ethics Statements and to review this new statement.
Women Physicians in Christ Annual Conference September 17-20, 2015 • Colorado Springs, Colorado
You are invited to join Women Physicians in Christ (formerly Women in Medicine and Dentistry) at their 2015 Annual Conference in Colorado Springs, Colorado and enjoy a unique fellowship of a gathering of like-minded women, committed to Christ and to the professions of medicine and dentistry. As a female healthcare professional, do you deal with the stresses of work, family, church and other activities? Are you struggling to stay focused on God’s plan for your life in the midst of personal and family issues? Then this unique conference is just for you. The WPC Annual Conference is designed to address the professional, emotional and spiritual needs of women physicians and dentists. It also provides continuing medical education on a variety of healthcare topics, with the goals of improving clinical knowledge and skills, in order to improve patient care outcomes. Student scholarships are available for students wanting to attend. For more information and to register, visit www.cmda.org/wpc. Christian Medical & Dental Associations www.cmda.org 5
transformations
Steury Scholarship Winner This year’s Steury Scholarship was awarded to Timothy and Avigael “Abby” Hereford. Timothy graduated from Colorado State University in 2003 with a bachelor’s degree in business administration, received a master’s in biblical history and geography from Jerusalem University College in 2010 and is now a second year medical student at University of Arkansas for Medical Sciences. Abby is a registered dietician, and they are also the parents to a 2-year-old daughter, Eve. Timothy grew up in a Christian home and was taught to love Jesus at a young age. “Somewhere along the way, I can’t pinpoint a date, I was saved by God’s grace. He did that for me, because in my sinful state I was helpless and could not save myself,” he said. After graduating college, he was invited to visit a medical missionary family in Kenya. That trip ended up being a life-altering adventure for him when he spent time with Dr. Bill and Laura Rhodes who were serving at Kapsowar Hospital. Dr. Rhodes was the only surgeon at the hospital. “The whole experience touched me deeply. I remember commenting to Dr. Rhodes that I was impressed with the work he did, and he told me that I, too, could do what he did. I left my time in Africa unsure of what the future would hold but I knew I wanted to be part of what God was doing in the developing world,” he said. Abby is Dr. Rhodes oldest daughter, and they fell in love during his trip to Kenya. They were married one year later in 2005. They began pursuing God’s calling on their
lives and spent a year in Indonesia working with Samaritan’s Purse rebuilding homes destroyed by the tsunami. Timothy said, “I became keenly aware of a glaring problem: lack of access to adequate healthcare. I began to think more seriously about going back to school and pursuing medicine.” In the intervening years, they spent three years living in Jerusalem before returning to the U.S. where Timothy began completing pre-med courses and applying for medical school. Their goal is to minister with a team of healthcare professionals in the developing world, and he wants to pursue orthopedic surgery as a specialty due to the lack of surgical specialists in the developing world. The purpose of the “Dr. and Mrs. Ernest Steury Medical Scholarship Fund” is to assist with the tuition of medical students who are committed to a career in foreign missions. Applications are evaluated on the basis of academic record, spiritual maturity, cross-cultural experience, leadership ability, the student’s sense of call, references and extracurricular activities/talents. For more information, visit www.cmda.org/scholarships.
Leaders Wanted to Transform Doctors, to Transform the World House of Representatives Are you interested in serving CMDA as a volunteer leader in the House of Representatives? CMDA’s House of Representatives meets once a year to approve bylaw changes, receive reports and approve the ethical positions of the organization. During the year, they also serve as two-way channels of communication between CMDA and its members. There is one representative from each state and from many of our local ministries. For more information about the House of Representatives, visit www.cmda.org/hor. Board of Trustees New trustees to CMDA’s Board of Trustees are nominated by a joint committee of the House of Representatives 6 Today’s Christian Doctor Fall 15
and the Board of Trustees. They look at the service record of potential nominees to CMDA, their leadership capabilities, expertise and Christian testimony. The nominees are then approved by both the house and the board. Trustees may serve up to two consecutive four-year terms and pay all their own expenses. The board meets three times a year to set policies, approve the budget, oversee finances and provide supervision to the CEO. For more information about the Board of Trustees, visit www.cmda.org/trustees.
transformations
New MEI Associate Director In the last five years, God has been greatly blessing and growing the work of Medical Education International, CMDA’s short-term academic missions outreach. The number of countries we serve each year has doubled, the number of teams tripled and the number of participants has quadrupled! And new requests keep coming in—the latest from Cuba, where we are planning to send our first MEI team this fall. To assist with the increasing workload, we are excited to introduce Dr. John Coppes as the new MEI Associate Director. Dr. Coppes received his medical degree from Indiana University School of Medicine in 1967 and completed his residency for OB/Gyn at Loma Linda University in California. He served as a medical officer in the U. S. Navy and recently retired from 42 years as an OB/Gyn, the final 18 years in Minnesota where he was affiliated with the Mayo Clinic Health System. He has led MEI teams to Ecuador and Madagascar, and he recently taught on an MEI team to a major medical university in China. This fall he will be part of an exploratory team to Chogoria Hospital in Kenya, where MEI has been asked to partner with a new family medicine residency. He and Joann, his wife of 50 years, now reside in Orlando, Florida. They have two children and four grandchildren.
INTER ACTIVE Visit www.cmda.org/mei to learn more about upcoming trips with Medical Education International.
In His Image encourages and provides great opportunities for international rotations during residency. I explored the option of long-term medical missions while spending a month overseas during my second year of residency at IHI. The faculty physicians and many of the program’s graduates have extensive experience in international medicine and were enthusiastic in helping to provide me with training and counsel for my future.
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After graduating from IHI, my family and I moved to Malawi, Africa. My husband teaches at a village school and I work at a hospital in the capital, treating patients and training Malawian family medicine residents. We are so incredibly thankful for the guidance and experiences God gave us through IHI as we prepared for service in Malawi!
Christian Medical & Dental Associations www.cmda.org 7
transformations
Member Award
In Memoriam
The American Association for Hand Surgery recently presented Louis L. Carter, Jr., MD, with the 2015 AAHS Humanitarian Award. This award was created to honor a deserving AAHS member who has made or continues to regularly make unique or special contributions and/or personal sacrifices for the betterment of humanitarian efforts. Dr. Carter was the recipient of CMDA’s 2013 Educator of the Year Award. Since 1996, Dr. Carter and his wife Anne have spent their lives traveling to teach basic plastic and hand surgery to general surgeons in various mission hospitals around the world. Their life-long dedication to education through healthcare missions continues to play an integral role in meeting the needs of so many across the globe.
John C. Willke, MD, passed away at the age of 89 on February 20, 2015 in Cincinnati, Ohio. He served in the U.S. Navy while pursuing his university studies, received a medical degree from the University of Cincinnati in 1948 and was an Air Force doctor in the early 1950s. Dr. Willke was a family practice physician who helped lead the modern antiabortion movement in the U.S. He served as president of the National Right to Life Committee for 10 years before retiring in 1991. He was the author of Handbook on Abortion, which was released in 1971 and sold more than 1.5 million copies. Dr. Willke served on the Board of Reference for the American Academy of Medical Ethics.
Proverbs 27:23
Time for a Financial Checkup?
c Memoriam and Honorarium Gifts d Gifts received April through June 2015 David Hill and Janet Lynn Chestnut in honor of John and Margaret Tarpley Dr. Ralph Buoncristiani in honor of Dr. Charles C. Wood Dr. John Ramey in honor of Drs. David Stevens and Gene Rudd Linda Worman in honor of Dr. David Stevens Joseph and Josephine Mowad in honor of Dr. and Mrs. James Jewell
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Thomas Forsberg in honor of Delores Kotschwar, MD Katherine Fox in honor of Dr. Ken Rutledge Jerry Huff in memory of Dr. Alva Bowen Weir, Jr. Patrick & Glenda Thomas in memory of Dr. Alva Bowen Weir, Jr. Carl & Lottye Huff in memory of Dr. Alva Bowen Weir, Jr. C.K. Robbins and J.R. Robbins in memory of Christy Fischer Kevin & Mary Earnest in memory of Christy Fischer David & Paula Schriemer in memory of Dr. Benjamin Lewis Barnett, Jr. William & Betty Wadland in memory of Dr. Benjamin Lewis Barnett, Jr.
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Richard Raborn in memory of his father, Robert, and brother, Doug
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8 Today’s Christian Doctor Fall 15
Larry Sabato in memory of Dr. Benjamin Lewis Barnett, Jr.
transformations
Event Calendar
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For more information, visit www.cmda.org/events. Marriage Enrichment Weekends September 25-27, 2015 – Minneapolis, Minnesota Oct. 30 - Nov. 1, 2015 – San Antonio, Texas www.cmda.org/marriage
Global Missions Health Conference November 5-7, 2015 Louisville, Kentucky www.cmda.org/events
Foundations for Christian Coaching October 9-10, 2015 Bristol, Tennessee www.cmda.org/coaching
Voice of Christian Doctor’s Media Training December 11-12, 2015 Bristol, Tennessee www.cmda.org/events
Midwest Fall Conference October 16-18, 2015 Norton Shores, Michigan www.cmda.org/events
Northeast Winter Conference January 15-17, 2016 North East, Maryland www.cmda.org/wc2016
The UNIVERSITY OF TENNESSEE COLLEGE OF MEDICINE Department of Family Medicine (Chattanooga Campus) invites applications from highly qualified and experienced Family Physicians to fill a full-time faculty position at our UTErlanger Medical Center Residency Program. Qualified applicants should hold an MD/DO degree, be board certified or eligible, and have proven experience as a clinician, clinical educator and leader. Responsibilities include training our six residents per class in both inpatient and outpatient care. OB and research skills negotiable. Academic rank and salary are commensurate with qualifications and experience. Send curriculum vitae and three references to: J. Mack Worthington, MD Professor and Chair Department of Family Medicine 1100 East Third Street Chattanooga, TN 37403 Phone (423) 778-2957 Please visit the following links for information about the University, Erlanger Health System and Chattanooga: www.utcomchatt.org, www.erlanger.org, www.chattanooga.gov and www.chattanoogafun.com.
Christian Medical & Dental Associations www.cmda.org 9
transformations
SEEN & HEARD THE CMDA VOICE
The CMDA Voice in Ministry “CMDA at our campus has allowed students to fellowship with one another in a casual spiritual community outside of lab and clinic. Over the years, a few students have even come to Christ through this organization. It is very valuable to have fellow believers to go through dental school with, as we can not only relate in our daily school and clinic struggles, but also encourage and build up one another in Christ.”
— CMDA dental student leader
“The Media Training class was exceptionally useful and very well-organized. You and the other extremely accomplished instructors were amazingly patient and provided very useful teaching. The gentle but incisive feedback you provided will be helpful in virtually all types of communication. Moreover, it was a privilege to spend time with so many outstanding Christians who model both servanthood and excellence. It was a very memorable experience.”
— Attendee at Voice of Christian Doctor’s Media Training
“I thoroughly enjoyed my first CMDA conference. I was truly touched and blown away by all of the goodness I heard and received this weekend. God has truly blessed!”
— Attendee at the Emerging Leaders in Dentistry Symposium
“I give because CMDA was like a lifeline when I was in medical school. I want that same thing for other students.”
— CMDA graduate member
“Since starting medical school, CMDA has been one of the most important groups to me. Going to each meeting keeps me focused on why I am in medical school in the first place.”
— CMDA student member
“We are totally and completely dependent on the efforts that you [faith-based groups] are making [in the battle for religious freedom].”
— U.S. Senator
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10 Today’s Christian Doctor Fall 15
The CMDA Voice in Missions “I appreciated hearing about ‘real life’ experience in the field. Not just theory, but reality.”
— Attendee at Center for Medical Missions’ New Medical Missionary Training
“I learned to listen more deeply to patients and not just rely on labs and tests. I learned to focus on the Spirit to lead me with every patient interaction. My greatest blessing from this trip was to see the hand of God work through my team despite us all not knowing each other. Truly, I felt we were one in Christ.”
— Physician on a GHO trip to Lebanon
“God reinforced the fact that I can trust Him for all things. Sharing God’s love has become a vital part of my life. I see more and more the incredible importance of sharing Christ’s love. Sharing the gospel message is far more important than my comfort. This trip was an exercise in trust and God proved time and time again that He is trustworthy.”
— Logistics team member on a GHO trip to Nicaragua
“This was one of our best trips. I believe that God had a plan and He intentionally limited our team to two ENTs and then His hand was present in (one team member’s) lost baggage. This forced us to focus upon relationships, rather than surgery, and maybe was God’s way of ensuring that we dealt with the most important issues and kept our focus upon Him… The physicians at Municipal and Pediatric Hospital seem genuine and building these relationships has provided witnessing opportunities. We were also able to continue relationships with younger residents and this is an exciting area for future growth.”
— Team leader on a MEI trip to Moldova
“I am no longer the young guy on the team, and I found myself in conversations with some of the less experienced team members, helping them process whatever it was that they were dealing with. I definitely feel blessed whenever I do this, because I am allowing the blessing to flow through me from the times other more experienced team members invested in me.”
— Dentist on a GHO trip to Ukraine
“God showed me how He can use me even when I feel completely unprepared and anxious. He also showed me how much need there is in Nicaragua for basic things that I take for granted every day, including knowledge and education. At the dinner that we held for our hosts, Dr. O. expressed that she had been praying for help, and that it would be from believers. She said that our team was sent to them from God. The staff at the radiation oncology center are anxiously awaiting our return.”
— Team leader on a MEI trip to Nicaragua
“I greatly appreciated the spiritual focus of the mission. Christ was first, medical care second. For the first time ever I prayed with complete strangers and use the Evangecube. It was a whole different experience providing healthcare in another part of the world with the limited pharmacy. I realized how much I do not know, but also was encouraged by what I did know. It was scary to pray with the patient the first time, but it became more and more comfortable. I prayed with a patient at home for the first time after this trip.”
??? HAVE YOU BEEN
TRANSFORMED? ARE YOU
TRANSFORMING OTHERS?
We want to hear from you Send your transformation story, letter or photos to communications@cmda.org or to P.O. Box 7500, Bristol, TN 37621. Please include an email address for us to contact you.
We want to hear your story It can be a simple comment about a CMDA ministry; it can be an account of your experiences on a missions trip; it can be a profile of a member who has had a huge impact upon you; it can be photos from a campus meeting; it can be statistics showing how your trip served the needy; it can truly be anything— we want to see how your work is making a difference.
We want to hear your ideas Do you have a great idea for Today’s Christian Doctor? Send your ideas to communications@cmda.org.
TRANSFORMATIONS SHOWCASING THE IMPACT OF CMDA ONE STORY AT A TIME
— Nurse practitioner on a GHO trip to Haiti
Christian Medical & Dental Associations www.cmda.org 11
cover story
We’ve Come a Long Way, Baby(ies)! by Jeffrey Keenan, MD INTER ACTIVE Visit www.cmda.org/reproductivetechnology for the latest information from CMDA about reproductive technology.
12 Today’s Christian Doctor Fall 15
A
fter lots of prayer and planning, the National Embryo Donation Center (NEDC) opened its doors in 2003 with a vision to become a leader in embryo donation and embryo adoption. Now, just 12 years later, they are celebrating the momentous arrival of their 500th baby and the NEDC is the leading comprehensive non-profit embryo donation program in the U.S., with more pregnancies through embryo adoption than any other like-minded program. And it all started with one tiny baby. Actually, two tiny babies. A set of twins. “It seems like both yesterday and a lifetime ago that our lives changed for the better when our twins were born,” stated Kim Lewis, mother to the first babies born through the NEDC and wife to Dr. Adam Lewis, an urgent care physician in Kingsport, Tennessee. “Time passes in the blink of an eye, yet it is almost hard to remember life without them.” The twins, Katie and Sam, turned 10 in March 2015. The fall 2005 issue of Today’s Christian Doctor included a special report entitled “A Fragile Gift,” which detailed the short but effective ministry of the recently established NEDC in Knoxville, Tennessee. The NEDC was created with a dual purpose: to protect the lives and dignity of frozen human embryos that would not be used by their genetic parents and to assist other infertile couples in having the family that they have longed for via donated embryos. In that article, Kim, who had recently given birth to the twins, talked about her struggle with infertility, “I was told I had premature ovarian failure, and that I would never have children unless I went through IVF cycle with an egg donor. Of course, we were devastated. I mean, our dream since we’d met had been to have a big family. After several years of praying, hoping, and nearly giving up, we heard about embryo adoption. It was perfect for us in that it combined the joy of adoption and the wonder of being able to experience pregnancy.”
It Was a Vision
“It was our CEO Dr. David Stevens’ idea,” stated CMDA Vice President for Communications Margie Shealy. “He felt like there needed to be ‘a high quality, scientifically and ethically sound way to help ensure that none of these invaluable human beings were discarded or sacrificed for research.’” That vision in 1999 led to what is today a bustling, freestanding embryo donation/adoption (ED/EA) clinic that is an anomaly among other non-profit ED/EA organizations. The NEDC is a comprehensive program handling all the medical, legal and social/emotional aspects of ED/EA in one location. Christian Medical & Dental Associations www.cmda.org 13
“
As a woman who struggled with unexplained infertility for years, I had almost given up hope that I would ever experience pregnancy. Embryo adoption restored that hope and through this miraculous gift, we now have a beautiful 4-year-old little girl. —Britney
”
Before the first embryo transfer could be performed or the first baby born, a lot of work, planning and prayer needed to be done. Dr. Stevens had the vision but needed a like-minded, compassionate physician who specialized in reproductive endocrinology and infertility. He found CMDA member Jeffrey Keenan, MD, who had more than 20 years’ experience in obstetrics, gynecology, reproductive endocrinology and infertility. Reflecting back on Dr. Stevens’ vision and the chain of events that occurred to make it happen, Dr. Keenan said, “God really put all the people and pieces together to form the NEDC. God made it happen; I couldn’t have done this myself.” That chain of events had brought him to what was then Baptist Women’s Hospital in West Knoxville, as
the hospital had recently approached him about relocating his practice, The Southeastern Fertility Center, there. CEO of Baptist Health System of East Tennessee (BHSET) Dale Collins immediately embraced and supported the NEDC concept by providing office and laboratory space along with promotional and administrative support to the organization. Embryologist Carol Sommerfelt, MS, ELD, stated, “When I became aware that Dr. Keenan and CMDA were setting up an embryo adoption center at the new Baptist Hospital for Women in Knoxville, I was intrigued and felt ‘called’ to apply for the embryologist position,” said Sommerfelt. “It was like God placed this in front of me and tugged at my ‘heart strings’ to become involved in a program to help ‘rescue’ these frozen embryos that I, as an embryologist for over 15 years, had contributed to their existence.” Sommerfelt was thrilled to work for an organization that held the same life-honoring beliefs that she did. Bethany Christian Services (BCS), led locally by Knoxville Director Nancy Lesslie, rounded out this divinely-directed group by contributing their adoption and social work expertise. Dr. Stevens served as the first board chairman, as well.
Spreading the Good News
The NEDC officially opened its doors in May 2003 and had approximately 50 sets of embryos by mid-2004. Word started spreading to fertility clinics and donated embryos began coming in from the Mayo Clinic, the University of Connecticut and other well-known clinics across the U.S., but more needed to be done. Through the end of 2005, the NEDC had just over 100 sets of donated embryos housed in their storage tanks and 18 babies born. Today, nearly 1,400 sets have been donated and more than 500 babies born. In order to protect all embryos and assist those who wish to donate for reproduction rather than destroy them, the NEDC has no minimum on the number that can be donated (as few as one) or their condition (poor embryo quality, possible genetic abnormalities, etc.). The largest set donated thus far contained 35 embryos. In 2002, Senator Arlen Specter (D-PA) proposed that
14 Today’s Christian Doctor Fall 15
In an effort to provide nationwide education on ED/ EA, the NEDC held a conference in 2008 in Arlington, Virginia called “Emerging Issues in Embryo Donation and Adoption.” In addition, the National Embryo Donation Academy (NEDA) was developed online with a self-paced learning module focusing on five ED/EA areas of study including nursing, medicine, law, social work and bio-analysis. The classes offer Continuing Education Units (CEUs) for professionals free of charge. Furthermore, NEDA faculty members presented their professional curricula at lecture dinners in 2011 and 2012 during the American Society of Reproductive Medicine (ASRM) conferences.
federal grant funds be appropriated to “launch a public awareness campaign to inform Americans about the existence of spare embryos and options for couples to adopt an embryo or embryos in order to bear children,” which created the Embryo Donation and/or Adoption Public Awareness Campaign housed under the Department of Health and Human Services. In 2004, the newly formed four-agency collaboration applied for a federal grant and received $304,299 in funding. Since that time, the NEDC has been awarded nearly $4 million in grants, funding that has allowed them to visit, either in person or through live televised presentations, nearly all of the 486 fertility clinics in the United States. Embryos have been donated from all 50 states and patients have traveled to Knoxville from 48 states for their embryo transfers.
The poll revealed that awareness of ED/EA by either term had stayed around 50 percent for the general public and 70 percent within the infertility community since 2009. The increase in awareness came from those who still had embryos in storage, with 98 percent being aware of either term. Additionally, more respondents had received information on ED/EA from a healthcare professional rather than from the media. This trending could be a direct correlation to ED/EA grant-related outreach efforts.
The efforts of the grant-funded programs over the years have had a noticeable impact on the awareness of ED/EA and the success of the NEDC. According to Sommerfelt, “When we first started, we performed donor embryo transfers cycles three times a year. We changed that to six times a year in 2006; we went from performing 30 to 40 transfers annually, to more than 120 transfers annually.” Today the NEDC has nearly reached the maximum number of patients it can see annually and is actively searching for an affiliate like-minded clinic, preferably in the Northeast, Midwest or West Coast, to expand the growing ministry of the NEDC.
Photo courtesy of Doug Wilson
One of the NEDC grant-funded awareness projects included an online poll to measure the level of ED/EA awareness, conducted in cooperation with Harris Interactive, Inc. in 2011. Previous surveys had been conducted in 2002 (by RESOLVE) and in 2007 and 2009 (by NEDC). Most of the survey questions were identical for the 2007, 2009, and 2011 polls for accurate comparison.
The NEDC also used grant funds to launch programs such as educational videos and podcasts, traditional magazine advertising in infertility consumer and industry-related magazines and adoption magazines, research publications, poster and conference presentations, a counseling hotline staffed by a social worker, embryo donor and recipient blogs, an ED/EA informational clearinghouse website, an adoption agency-focused ED/EA education website, secure online embryo donor and recipient applications, etc.
“
To see my children as tiny embryos, who survived seven years frozen in time, grow into thriving five year olds is nothing short of miraculous; embryo adoption was an answer to prayer that opened the door to experience motherhood in a way that was once unimaginable. —Jessica
”
Christian Medical & Dental Associations www.cmda.org 15
male cancer patients has evolved into informational cocktail parties promoting this usually unnecessary and costly procedure to delay motherhood. But, for some, it is an answer to prayer. For women who are aware that their egg supply is starting to decrease (as shown by a simple test for ovarian reserve), egg freezing for future IVF cycles reduces the number of embryos created per cycle because only a few eggs are thawed and fertilized per use while the rest remain frozen. Roughly, 10 frozen eggs will result in four to six embryos which equal two to three attempts at pregnancy with two embryos each.
“
As the NEDC’s embryologist, Sommerfelt has the first contact with these frozen lives after they are adopted. “My greatest joy is to hear about the happiness these donor-embryo-conceived children have brought their parents, many of whom came to the NEDC from across the U.S. and Canada. Receiving birth announcements, pictures, or actually meeting and holding the babies is my greatest reward for helping these couples.”
What a celebration of life it has been in remembering our journey with our miracle baby who was born two years ago. Her life is truly a celebration each day.
”
— Sarah
Lives Waiting to be Lived
According to the Center for Disease Control (CDC), one in seven couples in the United States now suffer with infertility. This number has been steadily increasing while the growth of assisted reproductive technology (ART), and the increasing number of frozen embryos grows along with it. “Our vision is that all frozen embryos would be used in attempts to create an ongoing pregnancy,” said Dr. Keenan. “In addition, we would like to see the huge excess of embryo cryopreservation in this country halted, and there are now excellent options for it utilizing oocyte (egg) vitrification (flash freezing).” Egg freezing has become increasingly popular in women’s infertility circles and is now being offered as a job benefit perk with some big businesses that depend on female employees to keep the corporate wheels turning and profits churning. What started as a way to protect the certain loss of fertility in fe16 Today’s Christian Doctor Fall 15
The Law and What’s in a Name
Embryo adoption is neither legally nor technically an adoption as that refers to the placement of a child after birth, but, to the many families that have been created through ED/EA, it is emotionally correct. Embryos are still considered property in all states and fall under property law versus adoption law. Though not ideal, it is less complicated and less expensive than adoption law and usually does not require an attorney. The laws surrounding the donating and receiving of human embryos for reproduction has not changed significantly over the last 12 years. While a few states have passed legislation on one or two particular areas of the process, there has not been a radical change overall.
Facebook Phenomenon
Earlier this year, mainstream and social media started paying more attention to this life-honoring family-building option as the NEDC was mentioned on Facebook in a post from one of its donors. Angel Watts was discouraged because the six embryos that she and her husband Jeff donated to the center in May 2013 had not been selected by a recipient. She had a list of requirements that the recipient couple had to meet including being under the age of 35, having a strong Christian marriage, being financially secure, being willing to take all six embryos and potentially raise six children, being in an open communication relationship so that the children will know their siblings, having roots in Tennessee and being within a five-hour drive of Nashville. Amazingly, she found her couple within three weeks. Even more surprising is the ongoing media interest this generated
which, in turn, has significantly increased inquiries from those wanting to donate and those submitting online recipient applications. Due to the media frenzy created by the Facebook post, the NEDC received inquiries or was interviewed by CNN.com, New York Times, Discovery Channel and Time Magazine, as well as numerous local and regional media outlets.
Building a Family
“From the beginning, I was thankful that embryo adoption gave me the chance to carry life inside me, to hold my babies in my arms, and to watch them grow—all things that I had struggled to accept would never happen after my diagnosis,” Kim Lewis recently reflected. “Now, 10 years later, I’m still thankful for those things. I’m thankful not just that I was able to have children, but that I was able to have these children. In the time we spent waiting and praying for a child, it was hard at times not to ask God ‘why?’ The answer is abundantly clear now when I look at my son and daughter. Through donors who chose to give them a chance at life and the NEDC that brought us together, God gave us the children He had meant for us all along.” As for the Lewis twins, Sam is an avid reader, loves to play video games and write his own comics. Katie enjoys running 5ks, playing basketball and horseback riding. “I would have never dreamed 12 years ago that we would have been as successful as we are today,” reflects Sommerfelt. “However, as I often told Dr. Keenan in the beginning when things weren’t as successful as we had hoped, we had to have faith that God will provide as no one said it would be easy.” She continues by saying, “Today, the increased numbers of those donating and adopting embryos seems to flood in to us through our website from couples who have learned about us from numerous different sources.” Sommerfelt reflected, “When I have time to contemplate my time with the NEDC, I feel honored to have helped to bring over 500 babies into the world!” Dr. Keenan and his wife Sandy were recently honored by CMDA with the 2015 President’s Heritage Award which is given to individuals whose lives and work support the mission of CMDA. Sandy, a registered nurse, assists her husband during the NEDC’s six, week-long donor embryo transfer cycles annually. Upon receiving the award Dr. Keenan replied, “(It’s been) quite a lot of work, but the number of blessings that have resulted are incalculable.”
What You Can Do Educate yourself. Visit www.embryodonation.org. Pray. We encourage you to pray for our ministry.
CMDA’s staff members pray for our efforts each time we go through a transfer cycle, and we would love for you to join them in lifting us up before our Heavenly Father.
Become an affiliate clinic. Do you specialize in
infertility or embryology or know a physician or embryologist who does and would be interested in helping to expand the work of the NEDC? Contact NEDC Grant/Finance Manager Dr. Lara Collins at lcollins@baby4me.net. Educate your patients. Contact the NEDC for bro-
chures and other educational materials for your patients and staff. We can also arrange a live, skype-type presentation. Contact Dr. Lara Collins at lcollins@baby4me.net.
About The Author JEFFREY KEENAN, MD, leads the National Embryo Donation Center team. He is a professor at the University of Tennessee Graduate College of Medicine, Dept. of OB/Gyn, as well as the director of its Division of Reproductive Endocrinology and Infertility. He serves as the medical director for both the non-profit NEDC and the Southeastern Fertility Center in Knoxville, Tennessee. Dr. Keenan is boarded in obstetrics and gynecology as well as reproductive endocrinology and infertility. Dr. Keenan graduated with honors from Jefferson Medical College, and he completed an internship at Mercy Hospital in Pittsburgh, Pennsylvania, a residency at Vanderbilt University Medical Center in Nashville, Tennessee and a fellowship at Hutzel Hospital/ Wayne State University in Detroit, Michigan. He is a member of the American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology, American Board of Bioanalysis and Christian Medical & Dental Associations. Christian Medical & Dental Associations www.cmda.org 17
INTER ACTIVE Visit www.cmda.org/humantrafficking to get involved with CMDA’s Commission on Human Trafficking.
“I
had just finished teaching at Grand Rounds about healthcare and human trafficking. There are so many points to make about the importance of involvement by healthcare professionals; it’s hard to get it all compressed down to one presentation. The line of questioners who came up afterwards was slowly diminishing when the next doctor in line stated what I hear after almost every lecture, ‘The signs you gave to identify a trafficked victim fit exactly with someone I saw in the ER last week. I didn’t know. I am so sorry I didn’t help.’” Are you like this doctor who didn’t know they were treating a victim of human trafficking? Have you ignored the warning signs because you weren’t sure what you could do to help? You are not alone. For healthcare professionals, helping those who have been trafficked reflects a Christ-like response. But what do the church’s world mission and our calling as Christians have to do with a response to human trafficking? In a word, everything! Why? Because when you consider what the Lord requires of us, it is “to act justly and to love mercy and to walk humbly…” (Micah 6:8, NIV 2011).
Human
Trafficking
As a global phenomenon, trafficking in persons (TIP) is fundamentally a human rights issue driven by many complex socio-economic factors. TIP dates back at least to the time of Joseph, who was sold by his family to foreigners (Genesis 37:27-28). Today, by force, fraud or coercion, people find themselves trapped in circumstances which negatively impact their freedom and dignity. They are forced to labor in such places as factories, fields, fisheries and brothels, suffering from acute and chronic health disorders as a result of dangerous working conditions, unscrupulous employment practices and little, if any, compensation or chance to escape. Men, women and children are trafficked, not just across borders or in a developing country, but within U.S. cities and towns. As a result, TIP has been likened to “modern-day slavery.” The prevalence of TIP is likely underestimated because of its illicit nature. According to the International Labor Organization, approximately 21 million people are enslaved today throughout the world, including in our own neighborhoods here in the U.S.1
What Can I Do About It?
by Allen Pelletier, MD; Clydette Powell, MD, MPH; and Gloria Halverson, MD
18 Today’s Christian Doctor Fall 15
The Beginning of a Journey— Dr. Pelletier’s Story I served several terms as a healthcare missionary in Africa and thought I was well informed and aware of the global problem of human trafficking. But after leaving the mission field and settling into an academic medical practice in Augusta, Georgia, I lapsed into thinking, “This is a problem somewhere else, not here, so it’s really not my concern.” I was shaken out of my complacency when the senior pastor at First Presbyterian Church of Augusta began working systematically through the so-called “minor prophets” of the Old Testament. One consistent theme he taught was that Yahweh—the Lord not just of Israel but all the nations—is holy and just. Unlike the gods of surrounding nations, He is not capricious or changeable. And He insists that His people—made in His image—act accordingly. To act justly and rightly is to reflect the very character of God; to act otherwise is the definition of injustice. One of the worst injustices singled out by the prophets was to treat other human beings bearing the image of God as commodities to be bought and sold. Challenged by this line of thinking, I approached our missions pastor with an idea: Could we address human trafficking during our upcoming annual church missions conference? As it turned out, others were thinking along similar lines. With a mandate from Scripture to bring the good news of liberty in Christ to all corners of life, we began.
8,000+ student state university. So we asked ourselves, “Besides the church, could we help to raise awareness about TIP and train professionals in healthcare and other relevant disciplines such as education, political science, criminal justice, counseling and others?”
Step 2 – Connecting the Dots
I began to map out these connections. Who might be interested and, equally important, who should be interested and trained? Could we leverage connections in the academic community and thereby educate healthcare providers and others in the community? Could we bring in outside speakers to raise interest?
Step 3 – Reaching Out to CMDA
CMDA has a Commission on Human Trafficking dedicated to helping members fight against human trafficking, and they have developed a set of online continuing medical education modules on TIP. These online modules are available to anyone interested. When I visited the commission’s webpage, I realized I had personal connections with several members who created the continuing education program. I reached out to Drs. Gloria Halverson and Clydette Powell: “Would you be interested in presenting a program on TIP in Augusta, Georgia?” They both responded with an enthusiastic, “Yes!”
Step 4 – Thinking Big
If we were going to bring in national experts, I thought: “Why not go all out?” I listed all the pos-
Step 1– A five loaves and two fish question: “What do you have?” We didn’t have much, at first. But our missions pastor knew several people in the church with an interest and concern for local TIP awareness. Although some were already involved in education and outreach ministries, they were isolated from one another and the larger church community. We realized we could join forces for such a project. Awareness of human trafficking is a pressing need for most healthcare professionals who care but are not trained, as they would not recognize a person who had been trafficked or even what to do if they suspected they were encountering one in the healthcare setting.2 A 2014 U.S. study reported 87.8 percent of trafficked women interviewed had seen a healthcare professional during their captivity but in no instance did that encounter contribute to them being freed.3 Augusta has a large academic medical center and other large hospitals, and many of the area’s physicians, dentists, nurses and therapists are involved in our church and other evangelical churches in the area. We are also home to an Christian Medical & Dental Associations www.cmda.org 19
sible venues and opportunities: Grand Rounds at a local hospital; meeting with community groups; a lecture at the local university; meeting with interested faculty and students; networking with community groups already involved at a local level; lectures and workshops at our local university; and meeting with the local CMDA chapters and groups. What about publicity? It turned out that the university’s public relations department was more than willing to help!
Step 5 – From Concept to Reality The program began taking shape with two connected areas of focus. One would center on the church missions conference and the second would focus on education and outreach to our academic community. We featured Drs. Powell and Halverson as the guest speakers at the opening program of our church’s annual missions conference. Our missions pastor organized a lunch for them to meet and network with representatives from several community groups already active in local TIP ministries. Dr. Halverson also works closely with the House of Hope, a ministry in Nicaragua that rescues women and children from human trafficking, then disciples them. Women are trained to make jewelry they can sell to support their families. As an added touch, we arranged for a representative from the House of Hope to come and display and sell jewelry during the conference. You can’t pull off a program like this without some last minute glitches. One appeared right at the start. At our opening banquet, Dr. Halverson pulled me aside: “You know, this material is pretty graphic, and I see a lot of young children here.” (Our church is blessed with many young families and LOTS of kids!) We had to improvise on the fly and quickly put together a separate non-TIP program for children under 12. Parents were encouraged to use their discretion for teenagers attending the TIP presentation in the larger sanctuary. With willing help (and more than a few prayers), we pulled it off, and Dr. Powell and Dr. Halverson gave their powerful presentation to a packed house of 500 church members and guests, with the central message that “the church is the answer.” For the second part of our program, we reached out to educate faculty and students at our medical and health professional schools, as well as our undergraduate campus. I arranged a Grand Rounds on TIP through my home Department of Family Medicine. We reached out to colleagues at outlying educational and medical sites to watch a live broadcast of the Grand Rounds. And then I came up with another idea: 20 Today’s Christian Doctor Fall 15
(From left to right) Drs. Gloria Halverson, Clydette Powell and Allen Pelletier answer questions about human trafficking after their presentation in Augusta, Georgia.
inviting remote audience participation by Twitter! In total, 60 faculty, residents and students from several other departments attended the Grand Rounds. An unknown number watched the program live (or in archived form) via the internet and submitted live Twitter questions. Drs. Powell and Halverson also gave a two-hour lecture seminar open to all students and faculty at our undergraduate campus. This was attended by about 250 faculty and students! Two local television stations featured these programs on their daily newscast. One local station sent a crew for media interviews. Our “hook” to the local viewing audience was that Augusta is home to a world famous golf tournament. Wherever such events happen that bring in large numbers of men, trafficking in persons is likely.
Step 6 – Assessing the Impact More than a year later, we are still seeing the impact of these programs. Some 25 guests attended the community workshop organized by our missions pastor, resulting in networking and a grassroots interchange in our community. Our church adopted the House of Hope as an ongoing project to support, and several church members have already visited the House of Hope twice this year. Finally, our church is hosting annual training programs on TIP for local and regional law enforcement officers. The Grand Rounds program generated great interest and exposure on our campuses, as well. Students and residents still remember the program and ask me about it, more than a year later. A sorority officer attended the undergraduate campus program and recently reached out to ask for an educational program on TIP for their
members. Using materials provided from CMDA and Drs. Halverson and Powell, I gave a lecture on TIP at a national CME course for primary care physicians.
What you can do?
You may not have all the resources and connections mentioned here. But you likely have more resources and tools at your disposal than you probably realize. Raising awareness about TIP is just one part of our mission as faithful servants of Christ to bring the gospel to bear on all of life. If you stop and think about it, it’s amazing what can be accomplished by one or two individuals. Who knows the impact we might have on individuals, communities and perhaps even entire societies? “…And who knows whether you have not come… for such a time as this?” (Esther 4:14, ESV).
How to Get Involved Get trained. Visit www.cmda.org/tip to access the
online continuing education modules about how you as a healthcare professional can make a difference in the fight against human trafficking. Attend the seminar sponsored by CMDA’s Commission on Human Trafficking on November 13-14, 2015 in Atlanta, Georgia to become more informed. For more information, visit www.cmda.org/humantrafficking.
Know the problem in your area.
Did you know that human trafficking occurs in both large urban areas and small towns? You can find out how prevalent human trafficking is in your state by visiting the National Human Trafficking Resource Center at www.traffickingresourcecenter.org.
Locate resources. CMDA offers a wide variety of
resources to help you get involved in the fight against human trafficking. You can also find more resources from the National Human Trafficking Resource Center and from the Administration for Children and Families in the U.S. Department of Health & Human Services.
Reach out.
Follow the example set by Dr. Pelletier and suggest a church event, present at a Grand Rounds program, train others, volunteer with a local TIP ministry or even go on a TIP-focused healthcare missions trip with CMDA’s Global Health Outreach. Bibliography 1 International Labor Organization, June 2012. http://www.ilo.org/global/ lang-en/index.html 2 Beck ME, Lineer MM, et al. Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics. 2015; 135 (4): e895 - e902 3 Lederer L, Wetzel C. The health consequences of human trafficking and their implications for identifying victims in healthcare facilities. Annals of healthcare law. 2014; 23: 61-90
About The Authors ALLEN PELLETIER, MD, is a graduate of the Louisiana State University School of Medicine in Shreveport. He is a board certified family physician, and professor in the Department of Family Medicine at Georgia Regents University in Augusta, Georgia. Along with his family, he served as a healthcare missionary in Nigeria with Mission to the World and SIM from 1991 to 1999. He has been an active CMDA member since 1981, is past president of the Memphis CMDA chapter and also served on the Commission for Continuing Medical and Dental Education. CLYDETTE POWELL, MD, MPH, serves as Medical Officer in the Bureau for Global Health at the U.S. Agency for International Development (Washington, D.C.). She serves on CMDA’s Commission for Human Trafficking and coauthored a book chapter on health and human trafficking. Dr. Powell was also a CMDA Trustee for eight years. With more than 30 years of experience in healthcare, she has worked in private medical practice, county and state government service, academia and non-governmental organizations. She is board certified in pediatrics, child neurology and preventive medicine/public health. Her medical degree was awarded from The Johns Hopkins School of Medicine and her master’s in public health (epidemiology) from the University of California (Los Angeles). GLORIA HALVERSON, MD, is a graduate of the Medical College of Wisconsin where she also did her internship and OB/ Gyn residency. She spends most of her professional time teaching missionary doctors and working in the area of human trafficking. She has led healthcare mission trips to work with women and children rescued from human trafficking in Nicaragua for Global Health Outreach. She also co-authored a book chapter for healthcare professionals dealing with trafficking victims in low resourced countries. She is a member of the Board of Trustees, chair of the Continuing Medical and Dental Education Commission and a member of the Commission on Human Trafficking. She is one of the co-authors of the CMDA online human trafficking modules. Christian Medical & Dental Associations www.cmda.org 21
C
alling me over to her bed in the ICU, she fumbled to grasp the lapels of my white coat. With surprising strength she drew me close to her face and said vehemently, “I don’t care what my doctor says, or what my family says, I just want to be kept comfortable until such time as I am no longer alive.” It was 1979 and I was an intern. Katherine was a 35-year-old math professor at the local university. Her aggressive breast cancer and its treatment had left her blind, bald, paraplegic and battling a bowel obstruction. Her oncologist had moved her to the ICU where her family—including her 5-year-old daughter—could only be with her for five minutes each hour. Due to Katherine’s completely inadequate pain control, I had been advocating with the oncologist for what was then an innovative treatment—a continuous opiate IV infusion. “She might get respiratory depression,” he said, “She’s only 35. We can’t just pull the plug on her.” But after Katherine’s fierce plea to me, I started the infusion, an action that could have been grounds for dis-
missal from my internship. Her desperate cry for help had pushed me into action. Within minutes she became, and remained, comfortable. She did not die for several days and had an interval of pain-free time with her family. When confronted by the oncologist, I replied, “You didn’t have to be here to watch her suffer.” It was also hard for him to argue with the success of the pain management. Now, 35 years later, I shudder a bit at my audacity, but the impulse to relieve Katherine’s suffering was overwhelming. It also foreshadowed my career as a palliative care physician, which began 10 years later when I discovered palliative care as a discipline and commenced my training. I still vividly remember the anguish I experienced when confronted with Katherine’s suffering. This memory gives me sympathy and compassion for colleagues who are so uncomfortable with the suffering of others that they are willing to participate in hastening the deaths of patients in their care.
Care, Not Killing The Most Excellent Way
by Margaret Cottle, MD, CCFP
“By the tender mercy of our God, the dawn from on high will break upon us, to give light to those who sit in darkness and in the shadow of death, to guide our feet into the way of peace” (“Song of Zachariah,” Luke 1:78-79, NRSV). INTER ACTIVE Visit www.cmda.org/pas for the latest information about physician-assisted suicide. 22 Today’s Christian Doctor Fall 15
The debate about physician-assisted suicide and euthanasia is not simply theoretical; it is fueled by the suffering of real patients like Katherine and their families. When we cannot end the suffering, the temptation to end the life of the sufferer becomes intense. But as Proverbs 14:12 says, “There is a way that seems right to a man, but in the end it leads to death.” After 2,400 years of Hippocratic medicine, we are facing a new reality in many Western democracies. Under the banner of freedom and radical autonomy, the so-called “right” to choose the time and manner of one’s death has become a new rallying cry for those who reject what they perceive as paternalism driven by religious belief. Country by country and state by state, the battle is being waged for the hearts and minds of citizens to sanction death as a part of healthcare under the guise of “compassion” and “choice.” On February 6, 2015, in its unanimous ruling in the Carter v. Canada case, the Supreme Court of Canada struck down the criminal code prohibitions against physicians aiding and abetting suicide. The ruling stated that its provisions apply to competent adults with a “grievous, irremediable condition” which does not need to be terminal in any way and specifically includes disability as a criterion. The person should be experiencing “intolerable suffering” as defined by the individual alone and specifically includes psychological suffering. The only other qualification is that the condition not be amenable to a treatment “acceptable” to the individual. As incredible as it may seem, the so-called “right” to die was predicated on the right to life. Since the patient might have to kill herself early to ensure that she was still physically able to carry out the suicide, the loss of this potential life was ruled as a breach of her right to life. Another disturbing element of the judgment was that the court found no material difference between actual killing and allowing to die, a foundational distinction in healthcare law. The ruling also allows both physician-assisted suicide and physician-administered euthanasia. Some troubling questions arise from the breadth of these parameters. How do we quantify the amount of suffering a person is experiencing? As one of my physician friends has asked, “Who do we say ‘no’ to and on what basis?” If the patient is the one who decides the severity of suffering she is experiencing and whether or not common treatments are acceptable to her, how do we ever say no to a request for euthanasia or assisted
suicide? How can we say that any reason is “trivial” if the patient is the arbiter of the degree of suffering and the acceptability of the treatment? Notice that by asking questions instead of making statements, the advocate of these practices is forced to address the practical consequences of those beliefs. Dismay over the Carter ruling, especially among Christian physicians, has been compounded by aggressive campaigns in several of the provincial bodies that license physicians (colleges). New policies are being introduced to compel physicians to perform—or formally refer for—any “services” that are legal. The patient’s right to access trumps the physician’s right to follow his or her judgment, conscience and religion. Christian physicians are challenging this in court, but the College of Physicians and Surgeons of Ontario has vowed to “vigorously defend” its new policy. What is a Christian physician or trainee to do? First, we can be people of hope as it says in Romans 15:13. None of this takes the Lord by surprise. He is still in control on the throne. Prayer, too, is a powerful intervention that has positive outcomes for both the one praying and the world that is the object of the prayers. And lifting each other up in prayer brings us together and strengthens our bonds of Christian community. Next, do not be deceived. These practices are extremely dangerous and utterly unnecessary. In places where euthanasia and physician-assisted suicide are legal, there has been a rapid expansion and total absence of enforcement of the so-called “safeguards.” Patients with mental illnesses, early stage eye disease and even ringing in the ears have been euthanized. Children and Christian Medical & Dental Associations www.cmda.org 23
patients with dementia, neither of whom can provide meaningful “consent,” have also been targets. In one study published in the Canadian Medical Association Journal in 2010, the physicians who reported that they caused the death of patients admitted anonymously that one in every three of those patients never gave explicit consent. 1 A study published in the New England Journal of Medicine in March 2015 reviewed the most recent data in Belgium around hastened death. It showed that 4.6 percent of all deaths in Belgium were euthanasia deaths, while 1.7 percent of all deaths were euthanasia deaths without the explicit consent of the patient.2 While these percentages seem rather small, serious concerns emerge when compared to the mortality statistics in the U.S. There were 2,596,993 deaths in the U.S. in 2013, and 4.6 percent of that is almost 120,000 deaths. This would qualify physician-assisted suicide and euthanasia as the sixth leading cause of death in the U.S., almost as many as the fifth leading cause of death, strokes, with about 129,000 deaths. And the 1.7 percent works out to more than 44,000 deaths and would be the 10th leading cause of death in the U.S. with a raw number close to the 47,000 citizens who died of kidney diseases.3 These are hardly trivial numbers and both are within the top 10 leading causes of death. Patients do not need hastened death; they need excellent care and a deep understanding of their difficult situations. They need all of us to be present with them
Get Involved
CMDA is currently working to fight legislation to legalize physician-assisted suicide in 29 states across the United States. With the leadership of volunteer state directors, we are currently organizing grassroots efforts to help raise awareness of the dangers of this legislation, and we need your help. Are you willing to join in our efforts to protect both you and your patients? Contact communications@cmda.org to get involved. Want to learn more about speaking out in the public square in the fight against physician-assisted suicide? Join us at Voice of Christian Doctor’s Media Training at CMDA’s headquarters in Bristol, Tennessee. This is an individualized training workshop to learn how to prepare for media interviews and give Christian perspectives on ethical questions and general health topics. Visit www.cmda.org/mediatraining for upcoming dates and to register. 24 Today’s Christian Doctor Fall 15
in profound solidarity. They need the palliative care resources that the majority of patients and families do not have. It is a major human rights violation to be suggesting death as an “answer” to our society’s lack of commitment to care for our vulnerable citizens! Every physician knows it is frighteningly easy for patients to die—keeping them alive is the hard work, and caring for them respectfully and compassionately in the process is even tougher. It takes courage and hope to treat patients, especially when the outcome is far from certain. Agreeing with patients that their lives are not worth living and helping them die destroys the trust between patients and physicians, while also revealing a distinct lack of ingenuity in our treatments. Real compassion is shown by finding ways to be innovative in our approach instead of just following a set of guidelines, thereby reaching people in despair, both at the end of life and in other circumstances, and making it clear they matter to us, their lives are important and we will be with them in their troubles. This care must include being willing to engage in conversations about hastened death. Simply telling patients, “I don’t have anything to do with those practices,” will only send them to other healthcare professionals who will facilitate their deaths. When we agree to have the tough conversations, we can rely on the Holy Spirit to guide us as we carefully explore the roots and causes behind the request for hastened death. Christian healthcare professionals have a dual duty in these challenging times—the duty to care deeply and skillfully for our patients and families, as well as the duty to act as salt and light to preserve and educate our society. Several excellent resources are available to help all physicians become competent in basic palliative care. We also need to speak up about these important issues within our own spheres of influence. Perhaps that is leading a Bible study at your church or a journal club at your hospital. Every mind and heart counts. “And now I will show you the most excellent way” (1 Corinthians 12:31b). The introduction to the 13th chapter of 1 Corinthians highlights the way of love as the most excellent way, and Paul reminds us of the attributes of true agape love: “Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. Love never fails” (1 Corinthians 13:4-8a). Our fellow sojourners in this world are hungry to come home, to be cared for with this Christ-like love that far surpasses any “rights” or human freedoms they think they lack and to have
About The Author
Emmanuel who journeys with them enfold them in His love. Look around! The world is overflowing with evidence of the Lord’s limitless creativity, His delightful imagination, His gracious provision and His loving kindness, even in difficult circumstances. He is inviting us to join Him as He cares for His children. What a privilege. Let’s not miss it! “And God is able to make all grace abound to you, so that in all things at all times, having all that you need, you will abound in every good work” (2 Corinthians 9:8). Additional Resources 1. Euthanasia Prevention Coalition – www.euthanasianewsworld.com 2. Christian Medical and Dental Society of Canada – www.cmdscanada.org Bibliography 1 CMAJ. Jun15;182(9):895-901. Epub 2010 May 17. Physician assisted deaths under the euthanasia law in Belgium: a population based survey 2 New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/ NEJMc1414527 3 http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm 6/16/2015
MARGARET COTTLE, MD, CCFP, is a palliative care physician in Vancouver, British Columbia. She graduated from medical school at the University of British Columbia in 1978 and has been caring for patients at the end of life for more than 26 years. She is a clinical instructor at the UBC medical school and has spoken in Canada, Mexico and the U.S. about ethical issues, caring for aging loved ones and palliative care. In 2006, she gave an invited presentation about end-of-life issues to members of the Canadian Parliament in Ottawa. She is a member of the American Academy of Hospice and Palliative Medicine, the Canadian Society of Palliative Care Physicians and the Latin American Palliative Care Association. She has been a member of the Physicians Resource Council for Focus on the Family for 25 years. Dr. Cottle and her husband Dr. Robin Cottle, an ophthalmologist, sponsor the UBC student chapter of the Christian Medical and Dental Society of Canada, hosting the students in their home every week for dinner and discussions.
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INTER ACTIVE Visit www.cmda.org/graceprescriptions for more information about learning how to share your faith in your practice.
Spiritual Assessment in Clinical Care PART 2 The LORD's LAP
by Walt Larimore, MD
I
n Part 1 of this article, we discussed how a spiritual assessment of each patient is now considered a core component of quality patient care. Since the mid1990s, I’ve taught the “GOD” spiritual assessment in CMDA’s Saline Solution and Grace Prescriptions conferences and small-group curricula. The “GOD” questions can be used when you take a social history from a patient: • G = God: –M ay I ask your faith background? Do you have a spiritual or faith preference? Is God, spirituality, religion or spiritual faith important to you now, or has it been in the past? • O = Others: –D o you now meet with others in religious or spiritual community, or have you in the past? If so, how often? How do you integrate with your faith community? • D = Do: – What can I do to assist you in incorporating your spiritual or religious faith into your medical care? Or, is there anything I can do to encourage your faith? May I pray with or for you? I’ve used this assessment with hundreds and hundreds of new patients over the last 25 years; however, this spiritual assessment tool, like most described in the medical literature, fails to inquire about a critical item involving spiritual health: religious struggle.
26 Today’s Christian Doctor Fall 15
A developing and robust literature shows religious struggle can predict mortality, as there has been shown to be an inverse association between faith and morbidity and mortality of various types. For example, a study conducted among inpatients at the Duke University Medical Center found patients (>55 years of age) who felt alienated from or unloved by God or attributed their illnesses to the devil were associated with a 16 percent to 28 percent increase in risk of dying during a two-year follow-up period, even when all other measured factors were controlled.1 I call these religious struggles the “LAP factors:” • L = Loved: – Patients who “questioned God’s love for me” had a 22 percent increased risk of mortality. • A = Abandoned: – Patients who “wondered whether God had abandoned me” had a 28 percent increased risk of mortality. • P = Punished: – Patients who “felt punished by God for my lack of devotion” had a 16 percent increased risk of mortality over the two years after hospital discharge, while those who “felt punished by the devil or “decided the devil made this happen” had a 19 percent increased risk of mortality.
One study of outpatients with diabetes, congestive heart failure or cancer found that while 52 percent reported no religious struggle, 15 percent reported moderate or high levels of religious struggle. Even younger patients reported high levels of religious struggle, and religious struggle was associated with higher levels of depressive symptoms and emotional distress in all three patient groups.2 While further research is needed on religious struggle, what is clear is that “clinicians should be attentive to signs of religious struggle” and “where patient’s responses indicate possible religious struggle, clinicians should consider referral to a trained, professional chaplain or pastoral counselor.”3 A New Tool When I began to realize the importance of these religious struggle factors and that I, as the health professional, needed to inquire about this, I developed and began using and teaching to my students and residents a new tool I call the “LORD’s LAP” assessment: • L = Lord • O = Others • R = Religious struggles or relationship • D = Do The “L,” “O,” and “D” questions of the “LORD’s LAP” tool are identical to the “GOD” questions. It’s the “R” part of this acrostic that’s new for me. After completing the “L” and “O” questions, I usually have a pretty good idea if the patient is a religious believer or not. Now, I’m not referring to whether they are a Christian or not, just whether they are or have been a religious believer. If so, I need to ask about any religious struggles they may have. To do this, I use what I call the “LAP” questions,” which are based upon the factors discussed above: • Love: Has this illness caused you to question God’s love for you? • Abandon: Has this illness led you to believe God has abandoned you? Have you asked God to heal you and He hasn’t? • Punish: Do you believe God or the devil is punishing you for something? If the patient answers positively to any of these questions, then the patient’s risk of mortality may be significantly increased over similar patients not experiencing religious struggle. If the patient does indicate they are having a religious struggle, then I need to either consult with or refer them to a pastor or Christian psychological professional. Or, if I feel comfortable providing spiritual
counsel, it certainly would be indicated. Now, it’s important to point out that I don’t usually take such actions immediately, as the patient likely has more pressing health concerns. But I also no longer ignore religious struggle, which I did for so many years. Furthermore, for the patient with religious struggle, I need to record this on the patient’s problem list. In fact, diagnostic coding systems have codes that can be applied to spiritual or religious struggles or problems. If the “L” and “O” questions reveal my patient has no religious or spiritual interests or beliefs at all, then the religious struggle (LAP) questions would not be indicated. So, for these patients, I briefly indicate I am in the “LORD’s LAP.” First of all, I thank the patient for their honesty, let them know I’m aware how difficult it can be to discuss religious or spiritual beliefs and tell them I appreciate their trust. Then I might share a brief testimony that may be something like, “Even though religion and spirituality are not important to you now, I often see patients who, when facing a health crisis or decision, will begin to have spiritual thoughts or questions. When I was younger, I had similar questions that resulted in my coming into a personal relationship with God. I just want you to know that if you ever want to discuss these things, just let me know.” Then, the final step of the “LORD” acrostic involves the “Do” questions. For believers, I might ask, “What can I do to assist you in incorporating your spiritual or religious faith into your medical care? Do you have any spiritual beliefs of which I need to be aware?” Or, “Is there anything I can do to encourage your faith? Do you need any spiritual resources or to see a chaplain?” Christian Medical & Dental Associations www.cmda.org 27
Or for a hospitalized patient I may add, “May I have the staff let your pastoral professional know you’re here?” For believers and non-believers, I may ask, “May I pray with or for you?” Putting It into Practice I remember the first patient with whom I used the “LAP” questions. I was rounding on a middle-aged man who had been admitted in respiratory distress secondary to bilateral pulmonary effusions secondary to lung cancer. During my social history, he indicated he frequently attended church and had done so since childhood. He prayed and studied the Bible, even memorizing dozens of verses. In the past, I would have offered to pray with and for him. But this day I asked him the LAP questions. I started with the “L” question: “Does this cause you to question God’s love for you?” His response surprised me as his lips began to tremble and his eyes watered. He could only nod his head. I then asked the “A” question: “Do you think God’s abandoned you?” His head dropped into his hands and he wept for a few moments. When he composed himself, he whispered, “I’ve asked Him again and again to heal me, and He hasn’t. Even went to a healing service. No luck there, either.” Taken aback a bit, I pressed on with the “P” question: “Do you believe God or the devil is punishing you for something?” Big tears continued to streak
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down his cheeks as he confessed, “I’ve sinned in so many ways. I’m sure this is God’s punishment of me.” I was grateful for his honesty, but even more grateful to the Lord for teaching me this new way to approach patients. Another patient, a lifelong, devout Buddhist who immigrated to the U.S. from Myanmar, shared that she was sure her chronic dermatitis was punishment from God for her lack of devotion. A Muslim patient, when asked about divine punishment as a cause for his injuries from a traumatic fall, looked at me as if I had two heads, smiled and replied, “Of course God’s punishing me. What other explanation could there be?” With these, and many other patients who have openly shared with me about their religious struggles, I simply would not have known had I not asked. In fact, over the 25 years in which I took spiritual assessments from my patients, I can only remember a few who spontaneously shared their religious struggles with me when I didn’t inquire. I can only wonder how many opportunities for significant spiritual impact passed by because I did not know how to ask. Conclusion In the last two years of systematically asking my religious or spiritual patients the “LAP” questions, my impression is that about one of five patients confesses to me one or more religious struggles. I’m thankful I’ve learned this new skill and pleased to see the many ways it helps me bear witness to God and His grace in my practice each day. One large review concluded, “The available data suggest that practitioners who make several small
28 Today’s Christian Doctor Fall 15
During your routine social history, begin with the LORD questions:
ê L = Lord May I ask your faith background? Do you have a spiritual or faith preference? Is God, spirituality, religion or spiritual faith important to you now, or has it been in the past?
ê O = Others Do you now meet with others in religious or spiritual community, or have you in the past? If so, how often? How do (or did) you integrate with your faith community?
ê
ê
IF THE PATIENT IS RELIGIOUS R = Religious Struggle Use the mnemonic “Are you in the LORD’s LAP?” by asking the three LAP questions.
IF THE PATIENT IS NOT RELIGIOUS R = Relationship Use the mnemonic, “I’m in the LORD’s LAP!” by sharing a brief faith flag or testimony.
ê
ê
D = Do What can I do to assist you in incorporating your spiritual or religious faith into your medical care? Is there anything I can do to encourage your faith? May I pray with or for you?
changes in how patients’ religious commitments are broached in clinical practice may enhance healthcare outcomes.”4 In a systematic review I published, my co-authors and I concluded, “Until there is evidence of harm from a clinician’s provision of either basic spiritual care or a spiritually sensitive practice, interested clinicians and systems should learn to assess their patients’ spiritual health and to provide indicated and desired spiritual intervention.”5 Duke University psychiatrist Harold Koenig, MD, writes, “At stake is the health and wellbeing of our patients and the satisfaction that we as healthcare providers experience in delivering care that addresses the whole person—body, mind and spirit.”6
Most of all, a spiritual assessment allows us, as followers of Jesus and Christian health professionals, to find out where our patients are in their spiritual journeys. It allows us to see if God is already at work in their lives and join Him there in His work of drawing men and women to Himself. Are you ready to start using these techniques in your practice? Visit www.cmda.org/graceprescriptions to learn how to share your faith in your practice. For an expanded version of both parts of this article and a complete list of citations, please visit www.cmda.org/spiritualassessment. Part 1 of Dr. Larimore’s article was published in the spring 2015 edition of Today’s Christian Doctor. Bibliography 1 Pargament, K, Koenig, HG, Tarakeshwar, N, et al. Religious struggle as a predictor of mortality among medically ill elderly patients: a twoyear longitudinal study. Arch Int Med. 2001(Aug);161(15):1881-1885. 2 Fitchett G, Murphy PE, Kim J, et al. Religious struggle: Prevalence, correlates and mental health risks in diabetic, congestive heart failure, and oncology patients. Int J Psych Med. 2004;34(2):179-196. 3 Fitchett. Ibid. 4 Matthews DA, McCullough ME, Larson DB, et al. Religious commitment and health status: A review of the research and implications for family medicine. Arch Fam Med. 1998(Mar);7(2):118-124. 5 Larimore, WL, Parker, M, Crowther, M. Should clinicians incorporate positive spirituality into their practices? What does the evidence say? Ann Behav Med. 2002 Winter;24(1):69-73. 6 Koenig, HG. Religion, Spirituality, and Health: The Research and Clinical Implications. ISRN Psychiatry. 2012;Article ID 278730.
About The Author
WALT LARIMORE, MD, is a lifetime member of CMDA. He has been named in Guide to America’s Top Family Doctors, The Best Doctors in America, Who’s Who in Medicine and Healthcare and Who’s Who in America. He and his wife of 40 years, Barb, reside in Colorado, have been named Educators of the Year by CMDA and are the parents of two adult children, the doting grandparents of two beautiful granddaughters and the adopted parents of Jack the Cat. Walt serves on the adjunct faculty of the In His Image Family Medicine Residency in Tulsa, Oklahoma and is the best-selling author of more than 30 books, 700 articles and 25 medical textbook chapters. You can find Walt’s daily health blog and daily devotions at www.DrWalt.com. Christian Medical & Dental Associations www.cmda.org 29
Lessons Learned
by Greg “Griff” Griffin, DMD
INTER ACTIVE Visit www.cmda.org/gho to learn more about upcoming trips with Global Health Outreach. 30 Today’s Christian Doctor Fall 15
When I first started going on mission trips with Global Health Outreach (GHO), I had no idea it would so drastically change my perspective of my existence here on earth, especially my relationship with Christ. My first trip was in the summer of 1998, just weeks after I graduated from dental school, and at that time in my life, it was surely just about adventure and trying to repay the Lord for blessing me with a great profession and family. But I missed the point entirely. We were in Ecuador less than 24 hours when we opened our makeshift clinic in the back of a half-built concrete block church in a field of waist-high thistle and weeds. I was the only dentist on our team and had what I thought was the complete anthology of dental knowledge in my head. I was ready to bring my dental “expertise” to bless and save as many poor mouths as my hands would allow. But in half an hour’s time, I was struck with the reality that I was completely and utterly sinking, and I spent that day desperately trying to get back to the surface...coughing and gasping for air. After our evening devotions, I sat alone in the little camp we were staying in and cried uncontrollably. I cried because I was scared; I cried because I was so incredibly inept; I cried because of all the pain, all the problems and all the disease—I could not even come close to providing even an ounce of relief to the enormous weight of the need. A gracious and loving nurse serving on the team, who had been on many trips, saw me struggling and gave me some insight that has stuck with me to this day. She said, “Griff, sometimes God asks us to give just a half a glass of water.” And that was my first lesson on being obedient, serving and allowing our God to handle the curing, the relief and the miracle of His peace and presence. Healthcare missions is so much more than providing healthcare to the needy. I don’t know how many trips it took me to start realizing this, but God is constantly changing my perspective. Here are just a few lessons I’ve learned through healthcare mission trips that have drastically altered my perception of living as a Christ follower.
Lesson #1
Serving in missions always puts me in positions that make me see how desperately I need Christ to lead me every minute, of every day. Several trips ago, a young man in Honduras brought
his elderly, blind grandfather to see us at our dental clinic. The two of them rode a little motorbike six hours to get to us and were waiting in line by 8 a.m. His chief complaint was a partially impacted canine that was protruding, causing his lip to always have an open sore. The surrounding scar was about the size of a quarter. Back here in the U.S., this problem would have been x-rayed and sent straight to the oral surgeon for treatment. But in this little town, in the middle of nowhere, this man did not have the benefit of radiographs or an oral surgeon...all he had was me. I really wanted to help the man but was unsure if I could pull it off as a general dentist. So I asked him to hang around and let me pray about it. And boy did I pray! I enlisted some of our team members to pray also, all morning long. After lunch I felt confident that the Lord was leading me to do the procedure. When I told the man we would do it, we prayed together and got started. It was, by far, the easiest extraction of the week! It went perfect and the man was so thankful, and I was so thankful that the Lord led me to do it and saw us through it.
Lesson #2
On short-term mission trips, I get a glimpse of Christ’s kingdom advancing across the globe, into all nations. “Panta ta ethne”—to ALL nations. All nations should absolutely be on my heart, because ALL nations are on God’s heart. Here in my little hometown of Lincolnton, Georgia, I see the Lord working and moving in my church, in our local ministries and even right here in my little dental practice. But if I experience the Lord exclusively on a local level, I am missing out on Christian Medical & Dental Associations www.cmda.org 31
one of the most magnificent, amazing and awesome characteristics of our God. And that is watching and being a part of His kingdom advancing all across our planet. The Lord is doing incredibly exciting things in other lands, and I want to see them and be a part of them if it is His will for me.
Lesson #3
It’s all about disciple-making. The last command Jesus gave to His disciples before He ascended to heaven is found in Matthew 28:18-20. It is the Great Commission. It is “great” because, if carried out properly, it ensures that the entire scope of humanity will get to know the one true gospel—that Christ died for us and made it possible for us to spend eternity with our Creator. It is a “co” mission because Jesus plainly tells us He will be with us as we go out and spread His Good News. We are not carrying out this task alone; we are “co” missioned with each other and more importantly with Christ Himself, through the Holy Spirit.
Disciple-making is a two-sided coin. On one side, I must be making disciples. (Keep in mind, this is not a calling, but a command.) One of the things GHO does so well is discipleship training for the local pastors of the towns we visit. We have partnered with Rev. Herb Hodges, Rev. Wade Trimmer and Downline Ministries, an organization based in Memphis, Tennessee. These folks are called by God to actively train Christ followers into being reproducers. As Christians, we are geared to go to church, help the needy and stand beside the broken, but we are called to so much more. We are commanded to MAKE disciples, and this is something that a lot of us just don’t know what that looks like day in and day out. In my dental career, my training has been the key to my abilities as a dentist. Likewise, the training I received from Downline, Herb and Wade have been the most important piece of the puzzle for me as I attempt to “Go therefore and make disciples of all nations…” (Matthew 28:19, ESV). The large majority of the pastors we partner with have little to no theological training (many do not even have a study Bible), so there is generally a strong component of pastoral discipleship training on the trips I lead with 32 Today’s Christian Doctor Fall 15
GHO. Joining together with these wonderful men and women of God is one of the major highlights of every trip. On the other side of the coin, I must be “being” discipled, meaning someone must be discipling me. You cannot make disciples of Christ if you are not a disciple yourself! Healthcare missions is the vehicle by which I have participated in both sides of the disciple-making coin. On my first GHO trip, I got to know two guys, each one much further along in their Christian walk. They both took an interest in me and began discipling me. One was Dr. Andy Sanders, an internal medicine physician who has led many trips all over the world and is passionate about God’s kingdom advancing to the ends of the earth. Throughout the years, Andy has taught me the Word, trained me to disciple others and challenged me to become a leader. He told me once that “a great leader is someone who leads people to places they would not be able to go on their own.” And that is just what he has done for me. There is no way I would have experienced all the awesome things I’ve seen God do on mission trips if Andy had not challenged and pushed me. Another was Lloyd DeFoor. Lloyd is a realtor in Georgia and is so much a country boy that he makes the “Duck Dynasty” guys look like they’re from New Jersey. Lloyd says the Lord called him to tithe not only his money but also his time. Four or five weeks a year, you will find Lloyd on the mission field, passing out the love of Christ to everyone he encounters. He is also
the tasks He lays before us. When we are in a remote area in the third world, we can’t get distracted by our cell phones or the “goings on” of everyday normal life. We are thrown off balance and begin to pray more, depend on the Lord more and, as a result, die to ourselves a little bit more. Sitting here in my comfortable chair in my living room, writing this article, makes me miss it so much. I am humbled at the thought of a small group far away praying right now for God to send a healthcare team to their village or little town to, as Jesus says in Luke 10:9, “…heal the sick there, and say to them, ‘The kingdom of God has come near to you’” (NKJV).
constantly serving locally. He taught me that every day is a mission trip and every place your feet go is a mission field. On my third mission trip, I met Dr. Stanley Anderson, a fellow dentist from Georgia who has also discipled me. If you ever go on a trip with Stanley, you will absolutely NEVER forget him! He is a certifiable nut, but is definitely screwed onto the right bolt! He usually always has a rubber cockroach on him to make sure we are all on our toes, and he can carry off a practical joke better than any man I have ever met. He should have been an actor or standup comedian. But when it comes to making disciples of Jesus Christ, he is no joker! He probably has a thousand guys like me in his life he has taught, challenged and held accountable to being a dedicated man of God. Stanley is the man in my life who asks the hard questions to make sure I stay on course to being a godly father and devoted husband. There is so much about being a disciple of Christ that I would have missed had it not been for missions. In fact, I am not sure I would even be someone who is trying to be a disciple and make disciples if it were not for missions. Short-term healthcare mission trips are the perfect venue for God to press us, lead us and even squeeze us into uncomfortable situations, situations where we have to sacrifice our thoughts and ideas in order to carry out
Please don’t misunderstand, many saints who never leave home make countless powerful disciples of Jesus, but for me, foreign missions lit my fire. Have you found what lights your fire? I am solidly convinced that everyone should go on a mission trip. The perspective you gain and the lessons you learn is like finally getting glasses when your vision has been blurry every day of your life. Or like watching a pile of puzzle pieces start to land in place, revealing a beautiful, breathtaking, artistic masterpiece! And the portrait it reveals, that we now see more clearly, is that of our Master, our Savior, Jesus Christ.
About The Author
GREG “GRIFF” GRIFFIN, DMD, lives in small town, Lincolnton, Georgia with his wife Julie, two sons Gregory and Garren and daughter Anna Pearl. Griff graduated from the Medical College of Georgia Dental School and has a God-given passion to use his profession to serve all God’s children both here in the U.S. and abroad. The Lord opened the door to foreign missions in 1998 while he was still a dental student. His oldest son was in the NICU after his birth for a few days and he met a doctor who invited him to go to Ecuador on a mission trip. The door has remained opened and Griff has joined GHO on many trips to Honduras and Nicaragua. Griff’s desire, above anything else, is to be used by Christ to make disciples for His kingdom and watch it grow for God’s glory. Photo © Mercer Harris Photography
Christian Medical & Dental Associations www.cmda.org 33
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Director of Medical Development — Evangelical Covenant Church affiliate, PCP, experiencing rapid growth, seeks a strategically-minded, contextuallysensitive director to support medical and public health practice in CongoDRC, directing a comprehensive set of programs to strengthen capacity of medical system. The DMD will provide vision and management of Medical Ambassadors program, network alliances, manage programs and train and lead medical practitioners to serve national initiatives. Some travel to Congo required. http://www.covchurch.org/jobs/.
never forgetting Jesus Christ is the true source of all healing. Through a strong spiritual bond with patients and providers alike, our physicians provide healing for body, mind and soul. Our faith-based organization offers a fantastic balance between personal, professional and spiritual endeavors— encouraging and supporting each provider’s missionary and volunteer efforts whenever possible. CCHS is adding providers, founded in Christian principles, in family practice (both outpatient only and with obstetrics), internal medicine and OB/Gyn. For details, please contact Rob Weigand on behalf of CCHS at 888-905-3244.
MEDICINES FOR MISSIONS
Oral and Maxillofacial Surgeon/Associateship — Leave the hustle of the city, come to a small town and find satisfaction in your family and professional life in a great facility with well-trained staff. High volume, high quality, full scope oral and maxillofacial surgery practice ready to welcome an energetic and personable surgeon into an associateship leading to partnership position. Compensation package includes: guaranteed salary, production bonus, medical and disability insurance, pension and profit sharing and paid vacation. We have two practices, Canterbury Oral and Maxillofacial Surgery and Southwest Oral and Maxillofacial Surgery (located in Hays, Kansas and Garden City, Kansas). For more information, go to www.kansasoms.com or contact Amy Huxman at 785-6212238 or amyhuxman@hotmail.com.
To place a classified advertisement, contact communications@cmda.org.
CMDA PLACEMENT SERVICES
BRINGING TOGETHER HEALTHCARE PROFESSIONALS TO FURTHER GOD’S KINGDOM We exist to glorify God by placing healthcare professionals and assisting them in finding God’s will for their careers. Our goal is to place healthcare professionals in an environment that will encourage ministry and also be pleasing to God. We make connections across the U.S. for physicians, dentists, other providers and practices. We have an established network consisting of hundreds of opportunities in various specialties. You will benefit from our experience and guidance. Every placement carries its own set of challenges. We want to get to know you on a personal basis to help find the perfect fit for you and your practice. P.O. Box 7500 •Bristol, TN 37621 888-690-9054 www.cmda.org/placement placement@cmda.org
IT MAKES A BIG DIFFERENCE “It makes a big difference having a Christian organization searching for us. They understand and care about our needs and finding those with a shared mission and vision.” - Lydia Best, MD; Detroit, Michigan
AN ANSWER TO PRAYER “Placement Services helped me navigate a complicated process and advocated for me when I was too busy or naïve to do so by myself. I am excited to work at a clinic with providers who share my values.” - Marlana Li, MD
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