Friday, March 17, 2006


Oh, Yeah, Baby!

So, here's the followup to my story from yesterday. I called to give her some test results (negative) and asked how she was doing.

"Great!" she said. "And guess what? I'm in shock! I told my boyfriend that I wouldn't have sex anymore and told him why - and he just said, 'Oh, ok, that's no problem. I still want to see you, though.' Cool, huh?"

Yeah, cool alright - and amazing - kinda makes me feel all warm and tingly inside, like maybe I'm doing what I'm supposed to be doing...

Thursday, March 16, 2006


Just Say No

It's remarkable, sometimes, what patients will talk about. Sex, for instance, comes up often enough in my practice that it is neither surprising nor uncomfortable for me to ask about it or to respond to questions about it. The details, though, sometimes are surprising - sometimes for me, sometimes for the patient.

A thirty-something recently divorced (or divorcing) woman came in the other day to be tested for sexually transmitted infections (STIs). Not an uncommon request, especially among singles but also even among married women. The conversation that ensued, though, was what set this visit apart from many others.

This particular woman, very attractive by anyone's standards - a statuesque, very pretty blonde - related the problems of the single life and what a drag it was. She said, "Oh, how I want to be married again!" It turns out the single life is not all it's shown to be on tv - and, in fact, carries with it significant risk (pregnancy or infection) and significant heartache (breakups and the games people play). So as we talked about her dissatisfaction with being single, and talked about the risks, she asked a not-so-uncommon question: "So, what am I supposed to do? How do I avoid this hassle of worry about STIs?"

We talked about condoms and other barrier methods - but really nothing protects as well as you'd like - so I also said, as I always do, "The only sure fire method to protect yourself is abstinence." She laughed and just about choked on hearing that come out of my mouth. She was just absolutely incredulous, and said, "Yeah, right! By the third date the guy is wondering what's wrong if there's no sex. And you think I can say no? I'd have nobody!"

Then, seeing that I was serious, she asked, with a now puzzled look, "Are you saying that some people do that - they date without sex?" I affirmed that there are such people, and that they decide together to be abstinent, and that they even purposefully set out to do so right from the beginning of their dating relationship.

It was like I was from Mars - she had no idea that such could be the case in this day and age in America! I could see a spark of interest, though, so I added, "And also, you know how you said you want to be married some day? Well, guess what? By saying yes to sex you've removed one of the strongest motivators to the guy wanting to move forward with marriage. You're giving away one of the privileges that comes with the committment!" She smiled, "You mean, like why buy a cow if you get the milk for free?"

Yeah, something like that! We finished the conversation by her asking, "Well, how would I tell someone that now I'm not going to do it?" That gave me hope that a light bulb had really gone off in her head! "Well, some people that I've seen have told their partner, after a bad scare, 'You know, this just isn't worth it. I was so freaked out by what happened last week that I just can't continue putting myself in that position anymore.' If he really loves you, he'll accept that statement and stay with you. If he really just loves the sex, he'll be gone."

Surprising ending to an STI visit? To me, no. To her, my guess is: a resounding yes!

Friday, March 03, 2006


Sunday Morning Surprise

Sometimes over-40 couples having their first baby are a bit on the nervous side - understandably so, don't you think? - but it can make things kind of interesting.

One couple I cared for were a great example of that. They always came in together, always had lots of questions, and were always appreciative of the time I spent with them. They had lots of extra visits and in a strange way endeared themselves to us with their nervousness and questions (rather than be an annoyance like you might think with someone who was always "bugging" you). Anyway, they finally, at nine months, right on schedule, delivered a nice healthy baby.

Then the post-partum questions began. Calls began coming in with questions about nursing, bleeding, cramps, etc. One Sunday morning while I was at the hospital making rounds I fielded a question from them. I could tell that the wife had gotten herself into a real tailspin with the combination of sleeplessness, cramping, and nursing problems all at once. I also knew that if I could actually see her and examine her I could reassure her better than just dealing with this over the phone, but I didn't want to add to their woes and make them bundle up the baby and get everything together to come to the hospital.

So, knowing that they lived fairly close to the hospital I suggested that I would make a home visit. They were shocked! "Really? You'd come here?" they asked. "Well, yes, it makes more sense than you coming in here," I found myself saying -after all they only lived a few minutes from the hospital.

Or so I thought! When I asked directions, I found out they lived about 30 minutes away, in another county! But now I was committed. So off I went. Sure enough, seeing her and spending time with her and her husband there at their house was very rewarding - to them for sure, but also for me.

Going the extra mile - well, in this case thirty! - blessed me that Sunday morn!

Wednesday, February 22, 2006


A Chance Encounter

My chance encounter with this sad young woman - 27 years old - and her parents was brief but notable, raising many questions in my mind - which will, as you'll see, remain unanswered - but also stirring an emotional response that was, at once, surprising yet understandable. I was seeing her for a colleague on his off day - thus the brief encounter with someone with whom I'll no doubt never have additional contact - following a surgery that had been performed for cancer.

Her story was significant in one important respect: Two years earlier she had received the news of her cancer - a cancer that is generally easily cured with surgery - but she had refused the life giving hysterectomy surgery. The only non-surgical option, medical therapy of the cancer, is usually not successful, and in her case, was not. Now she had been readmitted because of extensive spread of this same cancer throughout her abdomen and pelvis; now she had undergone the surgery previously declined; now she was dying of a cancer that should have been easily cured.

So my visit with her, "rounds" as we say, was to assess her condition on that post-operative day and to see that her medical needs were attended to until the next day when my colleague would return. My visit with her coincided with a visit by her parents: She, gaunt and pale, in bed, answering questions with a weak thin voice; they, worried, with pleading looks, asking with their eyes, "Will this new doctor be the one to bring healing?" Sadly, no.

Heartache filled the room, evident for all to see - parents watching a daughter terminally ill, she wanting more than anything for a miracle, them all wondering how they had arrived at this point in time in this condition, silently ignoring the question that rose above all else - "Why didn't I ... ?"

My heart broke particularly for the parents - the pain of seeing one loved as dearly as a daughter can be loved, slowly yet inexorably slipping away from them. This quiet, unimaginable torment - powerlessness in the face of this great impending loss - was almost more than one could endure, and I found myself pained as I looked into their eyes: I averted my gaze. I couldn't help, though, but to imagine for them to a pain greater still that awaited.

The unhelpful questions will remain unanswered: What could have possibly seemed so important two years earlier that would have led to the improbable decision to forego surgery in favor of a doomed medical regimen? Fear of surgery? Distrust of the doctor's diagnosis and prognosis? Unyielding desire to hold onto her future fertility?

This brief, chance encounter: for me a personal reminder of a parent's painful love journey with their children, with relentlessly haunting questions of what could have been...

Sunday, February 19, 2006


True Beauty

The anesthesiologist was ready to give the patient the medicine to make her go asleep when the patient asked, "Do you mind if I pray before you put me to sleep?" We were all gathered there, ready to begin - the anesthesiologist, the surgeon (me), the assistant surgeon, the scrub nurse, the circulating nurse - and one sensed a feeling of "Well, if you must" among those present, but of course I said, "Yes, please, go ahead."

I expected - I think we all did - a prayer asking God's protection during the surgery. Instead, we were treated to her beautiful intercession for each of us there in the room. She asked God's blessing on each of us at our homes, for the rest of the day ahead of us, and in our marriages. She praised God for His care over each of us. She never once asked anything for herself - just for us. When she finished, she said simply, "In Jesus' name, amen," and we each also humbly added our amens to hers.

The anesthesiologist then said, for all of us, "That was beautiful. Thank you" and gave her the medicine to have her go asleep. There was silence in the room for a minute as we all considered what we had just witnessed.

This woman, who was herself in such a vulnerable and frightening situation - about to undergo surgery - had on her heart not herself and her concerns, but us - selflessly intervening with God on our behalf, on behalf of people who (except for me) she would likely never see again.

What a testimony to the relationship she obviously felt with God and Christ; a testimony to the confidence she obviously had in Him. Beauty - pure and simple!

Sunday, February 12, 2006


He Is

Mom and daughter - she about ten years old - were there for the ultrasound, a chance to share the joy of seeing the baby at this early stage of development, the mom being less than three months along. Little did they know - either one of them - the real lesson that awaited them.

Bright smiles of anticipation turned inexorably to horror as we searched in vain for the baby's heart beat - and this little girl, in as poignant a moment as one can imagine, with the realization that this baby sister or brother was not going to be, and with the most gut-wrenching anguished expression on her little angelic face, ran to her mom and buried her head on her breast, with great sobs and tears. Mom, overcome with sadness, held her daughter close while I, with a gentle touch of support, watched - the silence broken only by their tearful sobs.

Yes, there was a lesson to be learned that sad morning - a lesson that touches on the very fragility and mystery of life to be sure, but also something more, something deeper - deeper for me at least, perhaps because this is a lesson I am in the midst of learning myself.

There was, in that little girl's immediate response - going to her mom, allowing herself to be swallowed up in those loving arms, reaching for someone bigger than life itself, someone able to take the pain away, to make things right - a demonstration of a universal principle of this life we live as humans.

Don't we all need someone or something bigger than life itself to make it through and over the bumps in life? Sudden shocking pain forces us to examine - in a hurry - where we find our true strength. For this little girl it was her mom. For us adults - and this is the lesson I am learning - it has to be something grand, rock solid, unyielding and never-changing. For me this strength and solace is found in only one place - my faith in a God who is, who can, and who always will.

Thursday, February 09, 2006


Justice or mercy

So I wondered some more about this sad display of humanity (read yesterday's post if you haven't already done so) - and these are the thoughts that pressed in:

1. This immediately disproves for me the post-modern notion that there are no absolutes - that right and wrong are somehow situational and defy absolute definition - for this event, the murder of an innocent baby, is wrong, wrong, wrong. Always, from the beginning of time to the end of time, in any and all cultural settings, this cannot ever be right in a moral sense.

2. This also challenges me to think of justice and mercy in a new way, or maybe to restate - with this stunning example in mind - my thinking about the interplay of justice and mercy.

Pure justice would say this woman should be condemned - period. She should accept - and we as a society of human beings needing to live together should demand - consequences for her abhorrent actions. But then pure mercy would say, as the previous Biblical quote implies, "Who among us has no sin?" and would ask for compassion and grace.

Does our reaction depend on her remorse? Maybe - but also we can at once hate the sin (and require justice - societally) and love the sinner (and offer compassion, mercy and grace - personally).

And then I wondered, and wondered again, whether I - me in my own humanity - would actually be capable of that personal response...

Hint: Not in my own power (Higher Power needed!)

Wednesday, February 08, 2006


Stone Throwers

Today I learned that a patient I delivered murdered her baby - the baby I helped her deliver just a few short months ago. How very tragic, senseless, and sad! A short news account related the story of this woman, arrested for the beating murder of her infant - other details absent - like the understanding (as if there could be any understanding??) of how a person could ever - even in their wildest fantasy or deepest, darkest hour - bring harm to an infant, helpless and innocent. What depths of depravity - or more likely psychopathic craziness - could yield this murderous result?

And then I thought some more, and Jesus' words came to me, "If any one of you is without sin, let him be the first to throw a stone at her."

I pondered the applicability here - certainly the civil authorities should throw the book at her - yes, that is their responsibility! - but I wondered, and wondered again, what my own personal response should be...

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