Puzzles and Promise amid a Pandemic

by Dr. Bill Maynard

Part 1          HOW LONG?

Be gracious to me, O Lord, for I am languishing;
heal me, O Lord, for my bones are troubled.
 My soul also is greatly troubled.
But you, O Lord—how long?        (Psalm 6:2,3)


Today marks the fourth week of Sarah’s COVID-19 infection.   As the video connects for our telehealth consultation, all I see initially is a blurred commotion.  A few seconds later the reason becomes obvious, as the audio kicks in, and I am greeted with a hail of coughing.

Once the paroxysm subsides and the image steadies, I can see Sarah sitting in her living room.  The previously healthy school teacher looks exhausted and haunted.  And little wonder – she has had fever, cough, and aches for over twenty days.

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by Dr. Bill Maynard

Let us be grateful for receiving a kingdom that cannot be shaken (Hebrews 12:28)

By mid- March we had three confirmed cases of COVID-19 among my patients.  One has died.  Another is recovered.  The third I am telephoning regularly, and his continued fevers and breathlessness nearly three weeks into the infection are keeping me on edge.  Coronavirus can worsen after a week, and many of the infections that prove fatal do not reveal their lethality initially. Sometimes a week into the illness, after a few days of seeming improvement, there is a second sickening – a renewed fever and cough with shortness of breath that can proceed to respiratory failure.

The public debate in the USA (and our whole new cultural glossary of medical terms) centers on life-saving ventilators.  While many patients can be preserved by mechanical ventilation, ICU doctors around the country now note that some of their ventilated patients who seem to be turning the corner can die suddenly when the virus unleashes its final, fatal assault: a directly toxic effect on heart muscle that causes cardiac arrest.  All the ventilators in the USA won’t stop that.

Recently I worked in a COVID testing site.  I could not know which patients had the infection at the time.  But without a doubt I saw the effects of the virus.  My first patient, a young lady with asthma, was literally quivering with fear.  Indeed, our whole world is being shaken.  Continue reading

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Re-thinking “Health”

by Morgan Wills, MD, FACP

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1

This simple yet sweeping definition of health was the first principle of the Constitution of the World Health Organization (WHO) upon its founding in 1946. Since that time, this ideal has had profound impact—directly and indirectly, for good and ill—on the well-being of individuals and whole populations worldwide. It is referred to formally in the setting of medical education and policymaking, and it also echoes more implicitly in the cultural rhetoric of advertising, industry, and the blogosphere worldwide.

Yet what should we make of this view of health? Should we as Christians embrace it? In this essay, I will consider the significance, background, and implications of this definition. I will argue that, although tantalizingly promising, it is dangerously utopian. What is needed is an explicitly human understanding of health to underlie our decisions about healthcare and the good of society.

This classic definition of health has much to commend itself. Conceived as a broader alternative to the reductionist biomedical model, it helpfully and explicitly validates the positive role of subjective well being and the interconnectedness of individual and community factors in health.2 As a core principle of WHO, it invited nations to expand the conceptual framework of their health systems beyond traditional boundaries and “to pay attention to what we now call the social determinants of health,” and likewise “opened the door for public accountability” for health related institutions.3

Yet this definition of health is not unproblematic. On a purely practical level, the definition has been criticized for its lack of operational value in a world where budgets are allocated based on strictly measurable goals.”4 The biggest conceptual problem with WHO’s core principle, however, is its conflation of health with happiness. These are distinct experiences whose relationship is neither fixed nor constant. As Sigmund Freud once observed after stopping smoking cigars, “I learned that health was to be had at a certain cost… Thus I am now better than I was, but not happier.”5 Once this distinction is blurred, the stage is set for a cascade of unintended consequences.

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by Dr. Bill Maynard

Helen is becoming more translucent by the moment, and eternity shimmers through her like light through a fraying curtain.  In fact, she has been almost see-through for years, as her parchment-like skin has thinned down like cellophane, revealing every blood vessel and bruise.  She has also been disappearing through emaciation from bowel obstructions.  Yet now she is vanishing into the distance.  She recedes farther every hour, and I am no longer trying desperately to haul her back.  No medicine can halt her journey now.

Sitting at her bedside, I keep mulling over lines from W. B. Yeats’ poem “Sailing to Byzantium”:

An aged man is but a paltry thing

A tattered coat upon a stick, unless

Soul clap it hands and sing, and louder sing

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THE LOBBY – by Dr. Bill Maynard

As always, the hospital lobby is staging a momentous drama.  The cavernous room is an interstice of human affairs – belonging neither to home, work, recreation, day, or night.  It holds the broken pieces of our lives – those often desperate, profoundly significant moments that we never forget.  Every day these jagged shards of hope and sorrow intersect here before my eyes in a mosaic of human passion.

The cast in this real life production are patients and their families.  On stage some of them cluster in warm circles of support.  The hope of renewed health or a reunion of loved ones brightens these little gatherings.  Elsewhere despair rules:  a man buries his face in his hands; expressions are abject or just blank.

But mostly the tone of this ever-unfolding play is exhaustion.  Many of the actors slump wearily in their seats.  A few even sprawl unceremoniously across the chairs.  There is something so vulnerable about someone sleeping in public, especially when snoring before the world!

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It Is Who We Become*

An article from our friend Dr. Kate Callaghan. This speech was given by Kate at MCF’s 2017 Graduation Commissioning ceremony, and was just published in the Linacre Quarterly last week!

“The most important thing in our life is not what we do, it’s who we become. What God gets out of our life is the person we become” (Willard 2006).

One of my college roommates was the first per- son who introduced me to this idea, and one of my favorite Christian thinkers, Dallas Willard, brought it back into my mind last week when I was listening to one of his teachings (Willard 2006).

As medical school has come to a close, it is this idea of becoming that has consumed much of my reflections on this season of life. While parts of this prioritization of becoming are deeply comforting and encouraging to me, other aspects of it fundamentally challenge my default settings and the way I live and move in the day-to-day. When I look back over the last four years, I’m similarly both challenged and encouraged when I think about who I’ve become. It has by no means been a linear progression of becoming more and more like Jesus. However, I think the most heartening thing, when I look back on the undulating curve of my life as a disciple in medical school, is that often in the moments where I seemed to have plummeted, the moments where I was my worst self and felt so lost in the rat race of accomplishing, God moved.

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When Failure Is an Option

Click here to listen to Dr. Tyler Cooper’s talk When Failure Is an Option.

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Engage or Run

“Engage or Run”: Reflections on my Intern Year By Brian Lindman, M.D.

Perhaps the most significant personal transformation of this intern year has been the shift of the fallenness and brokenness of this world from an intellectual apprehension and more theoretical consideration to a monkey on my back that weighs me down, beats me down, taunts me, and dares me to give up and give in. Did I know the world was fallen, cursed, and broken before this year? Yes. Had I experienced it? Yes, but… my experience was far more limited. My life was insulated, with walls around it, protecting me from having to “touch” the brokenness in all its messiness and ugliness. The brokenness I had experienced previously in my own life and the lives of my close friends and family always seemed finite and fixable; it did not seem out of control. Was I wrong to see it this way? Sure, in some sense. Was I blind to the infiniteness of sin even if more “minor”? Probably. But that is not my point here. My point is an existential, internal, emotional one. In some ways, I felt like sin, the fall, and its ramifications were contained. But, over the course of this year, that feeling has been destroyed.

My clinic and inpatient experience is an uninterrupted procession of people with poor insurance, an inability to afford medications, unaware of the seriousness of their medical problems, obese, poorly groomed, smelling, with grandchildren who steal their food, husbands who abuse them, addicted to cocaine, alcohol, or cigarettes, asking for the newest Viagra equivalent to keep up with his 2 girlfriends who don’t know about each other, paging me once a month for a refill on Percocet for chronic pain of dubious etiology, complaining of joint pain while not recognizing that their body mass index of 35 may have something to do with it, letting their blood sugars go unchecked for two years and letting a foot ulcer develop out of control to the point where an amputation is the only option, arrested for drug possession, admitted for an abscess in the groin because there was nowhere else to shoot the drugs than under the skin, not being able to be placed out of the hospital (including to the prison from which he came) because he is such a difficult/manipulative person to deal with, someone admitted from a psych hospital for chest pain where she was involuntarily committed after trying to stab her husband with a knife, a lady admitted with chest pain on the anniversary of her son being shot in the head.

In the face of this, what is one to do? Everything in me wants to run, retreat, disengage, turn off my pager, get these people out of my office or off my inpatient census. I get depressed, impatient, and distant. I get angry at these people because they have so many problems and so many non-descript complaints that I don’t know where to start and I don’t feel like I have the time, energy, or resources to get started. My tendency towards condescension and pride reaches new heights as my

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Hidden Figures: The Untold Story of Entrepreneurial Christians who Shaped the Roots of Western Health Care

Click here to register.
Thursday, May 4
Fellowship & Heavy Hors d’Oeuvres 6-7 pm
Lecture 7-8 pm
Panel and Q&A 8-8:30 pm
Mike and Linda Curb Medical Learning Center

Saint Thomas West Hospital
4220 Harding Road
Nashville, TN 37205

  • follow signs on our campus to the Seton Parking Garage
  • Take the elevators in the garage to the hospital entrance.              
  • From there, follow signs through the main corridor to the “Medical Learning Center.”

Who: All are welcome!  Students, Nurses, Doctors, Trainees, Family and Friends! 

What: We are co-hosting with Siloam, CMA, SSCD and St. Thomas an awesome new lecture series on May 4. Our first lecture in this new series will be about the history of the church and its role in the formation of Western medicine called Hidden Figures: The Untold Story of Entrepreneurial Christians who Shaped the Roots of Western Health Care. Our speaker will be Gary B. Ferngren, PhD, professor of history at Oregon State University and professor of the history of medicine in the I. M. Sechenov First Moscow State Medical University. He has written numerous volumes on the History of the Church and medicine. Please RSVP below…

Click here to register.

Church History and Med

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Doctors Fail to Address Patients’ Spiritual Needs

Interesting article about Doctors and their (in)ability to talk about matters of faith…

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