11.29.17

goliath

Posted in Uncategorized at 11:56 pm by Administrator

at lunch today, i found myself needing to connect with God, and as i was attempting to focus my thoughts and pray, a bird landed right next to me in the bushes, crashing through branches with a loud flutter of wings. “look at the birds of the air,” i remembered, and i found my prayer. “back when i was just a student,” i confessed, “you were the hope of a real future for me. but now that i am what i am, taking care of others, you are to me not only my hope but also my protector, my savior, my truth, and my lord. you are so much more to me now than you ever were before. how i need you…”

the prayer made me think on many things. do i truly value the Word of God as i should? i think that i and my church community seek to find in scripture that which validates our felt experience of God—but am i missing something by not seeking the truth of God simply through what is written? to what degree am i assuming things about God that resonate with what i am, as opposed to conforming to the fact of God as presented by God’s chosen representatives? i want God to know that i am willing to set aside all my sensibilities, however liberal, progressive, and true i believe them to be, in my quest for God’s truth. and if God is indeed wrathful, uncompromising, and bent on war, just as He is merciful and kind, then i will submit to that wrathful God—because it is not for me to judge what is good about the Lord. whatever God really is, this is what i will dedicate myself to. and as for how the world and its people want to view God, i really couldn’t care less. because i know myself to be a fool, i know that the opinions of others about what God is or ought to be are utterly meaningless. the Lord put to death the Canaanite peoples, but here and now He has spared me. that is good enough for me; and that will always be good enough for me.

and so, with this context in mind, i turn my thoughts to david and goliath.

within this past year, i wrote about how my 20s were the decade of Jonah, my 30s were the decade of Joseph, and now my 40s are the decade of King David. for each season of my life, there has been one main point of reference for me in scripture—a person and his unique struggle. during my jonah period, i wrestled with an idea of my life that i resented; like jonah, i resisted God and His design. during my joseph years, i found myself working for people and for organizations that embraced values and cultures that i found oppressive and even opposed to what is good. like joseph in potiphar’s house, i struggled to see the meaning and joy in the work of my days. and now, in my 40s, i find myself thinking frequently about David, the enneagram 4, the passionate, deeply injured, violent, and frequently misguided young man surrounded by enemies and filled with lofty ambitions. he remains for me, without a doubt, the most compelling and realistic character of the biblical narrative—more accessible than Christ, more human than Adam, and more authentic than Paul. David was a man that i am beginning to understand in many ways.

but there is one thing about the story of David that i have struggled to understand over the years. what possessed him to take the field against Goliath? i have been mulling it over recently, and here are some of my latest thoughts.

it would be one thing if David had simply been commanded by God to fight Goliath and been given every reassurance through a heavenly vision that he would prevail. but the narrative does not imply such a command; and David never describes the event in these terms. no, this was the story of a young man, a boy even, who was taking food to his brothers and found himself, absent of any preconception, challenging the seemingly indomitable Philistine giant. it’s a decision that David makes in the spur of the moment, and it is one that he was not required to make for any reason other than his own inclinations. thus, i am struck with this fact: there was within the child David a deep, powerful, and relentless desire that preceded his encounter with Goliath and found its natural expression in the moment that David made his choice to seek another man’s death at risk of his own.

neither was this a moment of sudden, fleeting passion that was immediately consummated. David had much time to rethink the decision he’d made. he was brought to King Saul, examined by the king, offered counsel against his seemingly rash decision, and even fitted with armor fit for the duel. these all represented multiple junctures at which David should have considered his fears, reconsidered his logic, and even changed his mind. that he did not again adds another dimension to my understanding of his motives; this was a child who had not only powerful feelings driving his decision but also a deep-seated and unwavering sense of identity that sustained these feelings, in the face of incredible and even unnecessary risk.

these observations made me think of another person who demonstrated similar persistence and passion in the midst of a life-changing decision. jacob, who put his relationships with his father and his brother forever in peril on account of his decision to steal his brother’s birthright, surely had an overpowering ambition driving him forward in spite of all potentially devastating consequences. as david risked both humiliation and death in his choice to fight Goliath, jacob put the future of his family at risk when he chose to rob his brother’s honor.

the example of jacob is helpful, because it illuminates some of david’s possible motivations. i cannot help but believe that what drove David to challenge Goliath was not simply a straightforward belief in God’s providence or a sudden indignation at Goliath’s heresies. i believe that David was willing to risk his life in that moment because he hated his life. like jacob, he hated being the forgotten child of the family; he hated being overlooked by his older brothers; he resented being thought of as insignificant, powerless, and without significant prospects in life. for this child with an overwhelming wish to be something other than he was, the decision to fight Goliath wasn’t merely justified; it was wholly necessary. either he would become the man of significance that he so hungered to become, or he would lose the life that was so dissatisfying to him.

with this perspective in mind, i am reminded that what drives a man to seek the favor of God often isn’t dutiful obedience or a simple recognition of what is good or right. it is passion, fueled by many basic, visceral things: a hatred of one’s insignificance, a longing for what only God can provide, and a relentless, aspirational hope. Jacob and David had great passion to be exceptional in God’s eyes, and while this passion produced sin in their lives, it also distinguished them in the eyes of God. i believe that while there are many qualities that are genuinely godly—patience, kindness, selflessness, humility, graciousness, and truthfulness (to borrow from 1 Corinthians 13)—there is this one quality that pleases God uniquely. it is not courage, as we are often inclined to think when we look at King David. no, it’s a passion that i would describe as an insatiable jealousy for the favor of God.

Peter had it, and he was humbled on account of it, but in the end he died for it and is remembered for it. John and James too, who gave up their lives for the right to sit with Christ. Jacob, as mentioned, staked everything on his ability to gain a blessing from the Almighty through duplicity. Joseph, it can be argued, alienated his brothers by asserting himself as singular among them in the eyes of God. but among these exceptional men is the exceptional man David, the single most striking example of this insatiable jealousy for the favor of God. he was an adulterer, a murderer, and at times a cruel man, but he loved God above all other things and sought to be exceptional in the Lord’s eyes. for this, he was cherished by God; and for this passion, he is remembered to this day as a forefather of the church.

choosing to face goliath (and with a mere sling at that) is the single most stupefying and illogical decision i can find in the lives of the biblical men. and for that reason, it is one of the most challenging moments in all of scripture. it forces me to reckon with my own ambitions, to search them out for just a seed of this reckless passion. is it true that i love God first and with all my might? among my many ambitions and great jealousies, is my aspiration to be known and recognized by my God chief among them? do i look at my life as an opportunity to be exceptional in my worship of His name and the building of His holy temple? i would hope that were my life to be examined by posterity, they would find this in me. i would hope that the story written about my life would be one of insatiable jealousy for the favor of God, manifested in boldness, in magnificence, and in stunning moments of seeming stupidity

11.27.17

forty-two

Posted in Uncategorized at 4:23 am by Administrator

it felt late, later than it was
as it was already dark
and because of this, we took our time.

we began with a wine
chosen for the region
of its birth, a vague memory

of our time in Tuscany
during a year of heavy rainfall
that made grapes heavy with rot.

we took antipasto with bread
which we swirled in the oil and vinegar.
they ran together

then separated out, like feelings
that ran with the years,
piquant, bitter, and sweet.

the table was cleared of crumbs.
a new fork and knife were placed
and as our blood ran warm and thin

with the wine, the pappardelle
and veal breast just then arrived.
between thoughtful bites, we talked

about the texture, taste,
and temperature
of all that we were taking in.

it’s not like it was,
when we sat here years ago
sitting with our single plates

and a sense of a stolen moment,
never enough money or time
to make it through three courses.

we ordered two cakes—
one pumpkin, the other chocolate—
and somewhere between the first bite

and the very last
i thought to myself
we did it right, we did well

to end up here
with this thick, gooey, chewy
sweet stuff in our mouths

and no thought
of what else we could have had
or could have been.

it was late, and we took our time,
and by the time i blew out the candle,
i had no thought of a wish.

42

11.22.17

dimensions

Posted in Uncategorized at 6:45 pm by Administrator

for the first time in my life, i’m working out with a trainer, and it’s completely changed the way i experience my body. exercise used to be a very predictable experience for me. i’d run, do push-ups and weights with my own dumbbells, and do pull-ups and stretches wherever i could find an available bar, and if i felt sore afterwards, it was a mild, familiar feeling. nowadays, i cannot predict how i will feel the next day. twice a week for an hour, i’m going through a timed circuit of at least a dozen different exercises, and it’s an arduous total body workout that invariably stresses muscles i was previously unaware of.

i have a workout buddy that’s going through this experience with me, and every time we get back together we compare notes on how we felt the day after. what i’ve discovered from observing our response to the high-intensity training is that the toughest exercises are the ones that force us to do active resistance work across two dimensions simultaneously. there’s the bitterly painful exercise i call the “plank pull”, in which you repeatedly pull a cord into the body with one hand while maintaining a horizontal plank position. there’s the other exercise i call the “ball roll” in which you have to rock a large exercise ball back and forth across the undersides of the forearms while maintaining a plank position at a moderate incline. what these exercises have in common is core muscle work against gravity and the simultaneous action of multiple large muscle groups against horizontal resistance. by comparison, strictly vertical work (step-ups, bench press, squats) can be incredibly stressful but doesn’t seem to drive up the heart rate with the same intensity, and the same is true for work isolated to a horizontal dimension (basically any seated exercise).

for most of my adult life, i’ve only done exercise in one dimension or the other, for the obvious reason that “multi-dimensional” exercise requires creativity and a certain element of masochism. multi-dimensional exertion is unnatural to ordinary life and generally requires ropes, weights, or other contraptions in order to manage properly. i could for instance turn my customary morning run into a two-dimensional exercise, but i’d have to do something like hold weights and swing my arms back and forth across my body as i ran. you can just imagine how awfully painful that would be, even if the weights were minimal.

i’ve certainly gained some learnings from these observations. the first thing i’ve recognized is that my traditional benchmark of fitness—how much weight i can push in one dimension or the other—is one marker of strength but possibly an inadequate one, depending on how many different muscle groups i’m assessing with the variety of exercises i benchmark. “fitness”, if i think about it, can never be an absolute thing. fitness only exists relative to the activity required or the physical feat that is ultimately (and perhaps arbitrarily) defined as its litmus test. is a champion marathon runner more “fit” than a world-class weightlifter? is a moderatively active man with 20% body fat necessarily less fit than a highly active man of the same age with 12% body fat but chronic joint injuries due to athletic activity? there are no straightforward answers to these questions. fitness is about what one requires of his or her own body. functionality, longevity, energy, and comfort all play into that conversation. i would daresay that it is even possible for exercise to reduce fitness.

the more profound learning i’ve gained perhaps is an observation i’ve made by analogy. spiritual fitness, if there is such a thing, is no less relative and individually defined. i have discovered for myself that spiritual fitness connotes many things—peace with self, broad perspective, and wisdom made complete in gratitude. when i think about the moments or experiences that forced me to grow spiritually, i recognize that these were moments that stretched me in multiple dimensions. more specifically, they were experiences that compelled me to reevaluate and change my relationships with my past and my future; and they were simultaneously experiences that drove me deeper into relationship with people in my communal circle. i’ve had plenty of experiences that have tested me in one dimension or the other; but it is not ordinary for me to go through a test that actively repositions me in both ways at the same time.

take for example the test of my marriage six years ago that rocked my world, broke my heart, and rebuilt the foundation of my life. i was in love with a woman other than my wife; how i got to that point, how i would work through those feelings, and how my wife and i could experience true reconciliation were the terribly difficult questions underlying the emotional turmoil of those times. at first, i committed myself to the work of one dimension—closing the distance with my wife, explaining what i had become and why, mitigating all tensions that were developing between us. i quickly discovered though that my ability to address the polarity between us would ultimately hinge on my ability to reckon with the depth of injury and dysfunction within myself and also on my willingness to rewrite the arc of my life, based on a new understanding of my past and of the future that i was meant for. it was the terribly hard work of challenging my identity and envisioning a new one. it was death and rebirth that transpired over years, and the experience made me realize spiritual muscles i’d never felt or understood before. the experience also helped me to discover God anew—the God who takes the death out of my life.

it was work in three dimensions for me, and it was similarly work in three dimensions for my wife, and it made me feel like i was dying, and perhaps in many ways i did. i’m not a better man for what i went through; i’m just more “fit” for the life i have chosen. i’m a better fit for the wife that i love and am committed to. and i’m more integrated into the idea of God that i have arrived at.

every year when i get to thanksgiving, i experience the holiday blues, because the days are shorter and the fall leaves make me think of death and loss. the four days off of work often feel strangely empty and listless, even for all the moments with family that they afford, and i find my ruminations going to dark places and to repressed ambitions. i begin thinking about the life i should have or the life i could have had. none of these thoughts make me better or healthier. they just remind me that i am who i am.

this Thanksgiving though, i’d like to examine myself in more than one dimension. i’d like to take stock of how i am doing in my relationships; how i am doing relative to what i aspire to become; and how i am experiencing myself, in that quiet and sober sense of self-regard. i have arrived at a season in my life when i recognize that many things are possible but so many of those things are not worthwhile. the accumulation of wealth, the achievement of greater honors, and the grooming of my children for future success strike me as futile pursuits, and to think of these things is to feel a kind of death crawling through my bones. i do not know what i want to be, not exactly, and this is because i do not really understand who i am or what i was meant for. but i get closer to that sense of identity when i feel pain—the pain of work across multiple dimensions. the past is unyielding; the future is unknowable; and the heart is deceiving, above all things. still, i commit myself to the exercise of life. to know oneself is to render oneself to death, with intention, skill, and feeling. thus do i live, and feel my way through the pitch black corridors that pass through Fall into the very depths of Winter

11.17.17

strong women

Posted in Uncategorized at 12:37 am by Administrator

my wife frequently tells others about who i was when she first married me. the stories are invariably meant to illuminate the extent of my personal growth, and it mostly pleases me to see the contrast.

but sometimes, on rare occasion, i feel that the description she offers of my 29 year-old self is exaggerated and unfair. and later, when we’re alone, i’ll try to defend the younger man i was, and she’ll disagree with my defense, and it will come down to our different accounts of the same core group of shared memories. “remember that fight we had?” she’ll say. and it will come back to me—all the anger and frustration of the moment—and i’ll describe what i experienced twelve years ago through the lens of my twenty-nine year old perspective. she’ll proceed to criticize that younger version of me, and i’ll defend him, and at some point my wife will ask me, “But can’t you see that now you’d never say that thing you said back then?” and it will strike me in that moment how futile it is for me to defend that young man who is gone. because she’s right; there’s no way i’d talk to her now like i did back then. and that just proves that there is no defense for those words.

i’ve always thought of myself as a progressive, egalitarian, and fair-minded person, but the fact of the matter is that i was clearly a more patriarchal, unconsciously biased, and chauvinistic version of myself when i was first married. i didn’t have the sexism of someone who overtly deprecated or demeaned women. i didn’t have an interest in inappropriate humor, and i respected my female friends and my mother. but what i did have was a particular sense of what i was entitled to as the hard-working breadwinner of the household. i felt that i deserved what in my mind was an equal division of domestic labor. i felt that i deserved consideration and respect, on my terms. i believed that i deserved appreciation for the sixty or seventy hours i was working every week. i demanded respect for my opinions, however impulsive or controversial they were in the heat of the moment. and i also believed that i merited the final word on anything important—a financial decision, a relationship decision, a moral resolution. in brief, i was a guy with lofty ideals but a selfish and self-oriented attitude, and i expected my wife to adapt to my intense, often overcrowded plate of anxieties and preoccupations.

what’s even worse is that in my weakest moments i betrayed the underlying beliefs that undergirded this particular form of personal privilege in my home. i quoted the bible. i pointed to examples of other couples in the church. i quoted academic texts and journal articles. i intellectualized my right to power, and when we disagreed, i bullied my wife by systematically invalidating her sources of truth. i did these things because she challenged me, because she did not share all of my values, and most of all because i was emotionally unhealthy and dealt with my dysfunctions by dominating my domestic partner.

my dysfunctions were not merely the product of a korean society and a korean church, even though i learned many destructive things in those settings. more fundamentally, i was the product of a childhood in which i felt chronically anxious and imminently threatened by two parents who did not love or respect each other. i’m not mad at my parents for not having loved each other. i’m actually grateful that they stuck it out despite how difficult their lives were together. but because i didn’t see it modeled well by my community or by my parents when i grew up, i had to learn about love—real love between equals—by trying it out with my wife and messing it up very badly for many years.

i continue to have significant issues with intimacy, vulnerability, and spontaneous affection, but i’m a better version of myself now for the thirteen years of marriage behind me. i’m a better person because my wife took issue with me, and i’m a better person because she took issue with the beliefs, assumptions, and prejudices that shaped me. i can say for certain now that i’m fundamentally changed on account of her influence. i can no longer justify any church practice that prohibits female leadership at any level. i can no longer justify male dominion of the household. more importantly, i can’t stomach the idea of anything other than egalitarian mutuality in the household. “complementarianism” is total bullshit. i’ve always known it in a theoretical sense, but now i know it personally. it’s wrong for heterosexual married men to believe that they’ve been accorded the right or privilege to lead, to work, and to achieve great things at the expense of the same opportunities for their wives. and it is wrong for children to grow up seeing this; it is wrong for them to learn this insidious patriarchy and to replicate it for their children.

the incredible price of this patriarchy goes beyond the traumatization of women and children. i’ve suffered for most of my life (until a year ago) with an addiction to pornography, and that didn’t change until i took a real journey into the roots of my attitude toward the women in my life. getting free of that addiction a year ago felt like a big win until i realized this was just scratching the surface. my capacity to objectify and reduce women is considerable and certainly goes beyond how i consume media for pleasure. i catch myself frequently imagining what women are thinking, expecting, or wanting from men, as if they cannot help but be defined by how men perceive them. this is the root of the evil, for me. i have to continually remind myself that this “exoticization” of the female experience is not only demeaning but also profoundly untrue.

so with this context established, when i hear the stories about harvey weinstein, george bush, roy moore, al franken, and the rest of us men (and yes, it is “us” in the fullest and most personal sense), i have two reactions. i feel paralyzed, because how can i criticize these men when i have been complicit in every psychological and spiritual sense in their crimes against women? how hypocritical would it be for me to throw a stone at these men? and yet, i also feel rage—deep, overpowering, insatiable rage—because my journey with my wife has enabled me to understand the awful, inescapable suffering that is uniquely inflicted by powerful, entitled, misogynistic men. i was one of them. i am one of them. to throw the stone, i must myself be stoned. but i’m willing to be stoned for this, because i despise that aspect of what i am. i was once “the man of the house”, God’s appointed leader to my wife, and that nauseating, deluded, and twisted sense of God’s truth is now a haunting memory to me and a cause of great shame. yes, i am a man who dominated a woman; i will regret that always.

i’ve previously written that progress for society will happen when female sexuality can be separated both from reproduction and from career advancement, and i still believe it. i would hope that someday women can lead not because they are favored by men but because they earned it. i would hope that someday women can have kids not because they birthed them but because they donated an egg the same way a man donated his sperm. and i would that someday a woman can have sex with a man on her terms and not have to worry about the consequences on her social standing or on her health, just the same way men have sex without consequences because they like it that way.

but above all, i hope that i can learn to respect my wife more deeply—and demonstrate that respect by submitting to her leadership and bending to her wisdom. there are men who perform admirably in public by calling their wives their better halves; frankly, that bullshit makes me angry every time, because it takes a privileged person to confer that honor. my wife is not my better half; she’s a whole unto herself, and i’m learning from her every day. her life is a source of fascination and hope for me, and life goes better for me the more interesting and successful her life becomes. i want to achieve many things in life, but one of the most important things i want to achieve is her career success. she’s given me the right and privilege to share in that success; and i take that very seriously.

my son is going to be an adolescent soon. he’s going to discover internet porn; he’s going to masturbate; he’s going to lust after girls or boys; he’s going to make relationship mistakes. he’s going to hope that he discovers the love of his life someday—and he may or may not find that person. none of these things are good or bad. my boy is going to be sexual, and that’s all there is to it. but being sexual does not mean that he must be aggressive, manipulative, or cruel to others. i want him to learn that he can experience sexual desire for someone and still be loving to that person.

my daughter is going to meet many bad men in her life, and i grieve this already. i want her to know that she has the right to demand better from men, even though they’ve learned many terrible terrible things from society, their parents, the bible, and the church. she has the right to demand equal, respectful treatment from other men and women, however inconceivable this may sometimes seem, and she has the right to punish men who believe themselves to be superior to her. she’ll get her hpv vaccines, she’ll take birth control when she’s in high school, and she’ll learn to protect herself on social media and in public. my daughter’s not going to take shit from men, and she’s not going to learn any bullshit from me. my wife and i did not suffer through all these years just to pass on more dysfunction to our kids. we’re going to leave the world better than we found it

11.13.17

felix

Posted in Uncategorized at 3:08 am by Administrator

i regret i didn’t visit you more. i regret it! there were just the four times. december, the month after you were first diagnosed with cancer. january, when you were gearing up for the bone marrow transplant. there was february, when you came to visit the clinic to tell us all how you were doing. and then there was may, after the bone marrow transplant had failed. i walked into your room, and i saw you—the thin, hollowed-out version of you—and i could not get a word out. i sat down, and you comforted me. it was fitting, in retrospect.

a year ago, i was at your sixtieth birthday party, an intimate and truly joyous affair, and your whole life was ahead of you. you were in love with a wonderful woman; you were planning new things for your career; you were getting back into religion, exercise, and books. it was a picture of you in your prime, truly in the moment and aware of how blessed you were, just weeks before you would come down with an intractable sinusitis that would turn into a new diagnosis of leukemia. i’ll never forget that night. you toasted us, and i believed that your very best years were ahead of you.

you deserved great years. not the years behind you, full of anxiety, work, and business. remember when we talked at the company retreat years ago (was it four years ago now?) and you pulled me aside and told me how much you regretted the years of long work weeks and time away from family. you told me not to get so absorbed in my work that i couldn’t see the important and precious things in life for what they were. that conversation too, i will never forget.

from the day seven and a half years ago that you interviewed me to be your successor, to the last time i ever saw you—crossing a side street at the cancer center on your way to chemo, masked up and hunched over—you were my mentor. you laughed big laughs with your patients, who later became my patients. you said kind things to me when i was struggling to make my way. you praised and lauded me in front of others, when i knew i was not filling your shoes. always, i had a picture of you in mind when i was burning out or laboring through those difficult clinic days. “what would felix be thinking right now?” i’d ask myself. and always the answer would come quickly. “felix would know that he is not the victim. felix would give everything he had to the suffering person in front of him.” you were my mentor, even when our paths did not cross for weeks on end, because i knew you, and because you knew me, and because we shared a work that was uniquely and wonderfully ours and ours alone.

i prayed for you like i prayed for my dad. i was sure that God would give you twenty-five more years of life. i even shared this conviction with you, and you believed. i think about that now, as your blood pressure drops, as your organs bleed internally, as your kidneys fail, as your lungs stretch from the force of ventilator air. you and i have seen so many people live and die bad deaths from AIDS; so you’ll understand why i do not pump my fist at God and ask Him how this is fair. the question is settled: it is not fair. all death is an outrage. it is an outrage. it is contrary to God’s nature, and it is a shocking and incomprehensible thing, and all creation on earth and in heaven grieves this terrible accident of our design. i will never accept it, and i will never have peace with it. but especially with you, a good man who lived a good life and gave me so much wisdom and joy, i am outraged and broken at the thought of your passing. i have loved you felix as a son should love his father, and i cannot let go of you. so you must tear yourself from my unrelenting grasp if you are to be free of me.

felix, i miss you so bad. i will always miss you

11.09.17

the bottle

Posted in Uncategorized at 10:45 pm by Administrator

the medical director of a clinic site at my organization asked me if i could drop in and talk to the doctors there about how to handle chronic pain patients. she told me that there’d been some recent patient complaints about the physicians and the way that they’d handled prescriptions of controlled medications like opioids and anxiolytics. i told her “sure thing” and put it on my calendar and didn’t really think anything more about it until today, when i drove over and showed up at their lunch meeting.

it turned out that in addition to the nine providers, the site administrator and her management team (an additional eight people) wanted to hear me talk, so it was a pretty crowded conference room when the meeting got started. they asked me if i had a powerpoint to project onto the screen, and i said no. they asked me if i needed any support for my presentation, and i told them i didn’t think it would really be a presentation at all. i just wanted to hear what was going on. so that’s how the meeting began; i asked the doctors and nurses to describe for me patients that they had recently struggled with. i asked for three volunteers. seven people ended up speaking up, and they talked for fifty minutes of our allotted hour about the chronic anxiety, chronic disease, and chronic pain of their most difficult patients.

the first person to speak up was a nurse practitioner, who described what it was like for her to evaluate a sick child, recommend a detailed plan of care, and then be told by the anxious father of the child that he wanted an antibiotic injection. when she recommended against that, the family left, went to the ER, got an antibiotic injection, and then returned to the clinic to see another provider and complain about her—the nurse who wasn’t even a doctor and who had refused to give them what they needed. the provider who received the complaint was there, and she talked about her experience of the very unpleasant father and the way she tried to manage that difficult encounter.

after the two of them relayed their story, i asked the first provider to describe how the whole encounter had made her feel. “frustrated and a little angry i guess” is what she said.

the second doctor talked about a chronically anxious patient who comes to see him every week and takes an hour of his time every visit, to talk about medically rare complications that he’s afraid of suffering in his lifetime. two nurses on his team piped in to mention how their attempts to reassure and redirect the patient were repeatedly dismissed, even with disdain. the stress of handling the patient’s anxieties were evidently affecting the whole care team; they all acknowledged a very similar experience of the patient.

the third and fourth doctors talked about chronic pain management. the third doc in particular, a veteran doctor of thirty years, talked at length about a variety of things: his fear of learning someday that a patient of his had overdosed, his general anxiety about all the opioid medications being demanded of him, his guilt and even shame about considering the fact that he had been the one to start opioids for some of them. i know this doctor well, and his style is generally one of dry and even sardonic humor, but today he was wrestling with himself, and all of it was serious. “was i responsible for putting some of these people on the path to addiction?” he asked us all. “i don’t know. i think it’s possible. but i just don’t know what to do.”

for fifty minutes, we listened to one another. then they looked at me, and i looked at the clock, and i realized that with the ten minutes remaining, they expected me to tell them how to manage these kinds of scenarios, how to handle these kinds of patients. and though ideas raced through my mind—tactics, strategies, communication tools—i realized in the moment that this wasn’t at all what they needed to hear.

so i told them what i’d heard them say. at first, what i’d heard was a familiar tale: a story about down-and-out patients, problems that needed fixing, an opportunity for better communication and service recovery. but when i closed my eyes and tried to forget who they were and what i knew about them, i heard something different from them: i heard a cry of the heart. “you were talking about the pains and struggles of your patients,” i said, “but what i heard was the story of your pain. and i don’t know if you knew you were doing it, or whether you heard it in what others were saying, but all of you were talking about a personal pain. the pain of seeing a patient in suffering. the pain of not being able to help that person. the pain of experiencing a patient’s anger directed at you. the pain of being helpless. it was your pain you described.”

and then i told them what Rich Bluni once shared with me, how everything we bring to work every day is like water in a bottle. every time we experience that kind of pain that undermines or demoralizes us, a little of that water gets poured out. and when we are wrestling with angry, dispirited, and suffering people hour to hour, day by day, we can be poured out to the point of emptiness. that’s when we get to sunday night and find ourselves unable to sleep, because of our dread of monday morning. that’s when we wonder which patient will be the one to break our spirit at last, the person who will be the reason we leave.

“i can share this with you because i’ve been there myself,” i said. “the question is not how we can manage the difficult patients. the real question is how we will manage ourselves, when we are running on empty.”

it was so quiet in the room then, and i opened my mouth to speak, but something inside of me broke. hearing the pain in the voices of the doctors and nurses whom i’d known but not known in this way had changed me. right there and then, i just broke down and began to cry.

i wasn’t the only one, i discovered. the medical director to my left was crying. the nurse practitioner who hadn’t given the injectable antibiotic was crying too. the look on the veteran doctor’s face had changed; he wasn’t smiling to himself as he usually does. it was just a moment of silence we shared, just a moment. but it felt profound to me, like shared grief.

and so i thanked them. i told them that the only way i’ve discovered to fill the bottle is to receive appreciation and to give it to others. i thanked them for persevering through the hateful patients, the anxious fathers, the distrustful and angry addicts, the hurtful encounters. i thanked them for hanging in there, because every now and then there is a patient that comes along who is looking for a positive life change and just needs the doctor who will speak a precious and good truth into his life. and because they are hanging in there through the tough times, they are there for that one patient, however rare, whose life will be transformed by them forever.

i’d already gone over by five minutes by that point. i asked every person in the room to do one thing: before the end of the week, to share a word of appreciation for one other person in the room. it’s that affirmation activity i talked about so many years ago, the moment when i caught a glimpse of what it really means to be in a spiritual community. and then the meeting was over. people were still crying. doctors were hugging each other. people came up to me to hug me. i felt like i wasn’t done crying, so i left the room and went to my car and cried some more.

it has been a hard, hard seven years taking care of patients in this city. it has been so hard, and it has changed me so much, to see how my patients live and how they die, to experience their anger at the world and at me, to suffer alongside of them, to hate them, and to love them as well. i realized, as i sobbed in my car, that my bottle is emptied on account of their despair, but it is filled when i share my pain.

right then, i got a text, as i sat in my car. it was from the second doctor, the one who had shared his story about the chronically anxious patient. “Thank you for your wise and inspiring words,” he said. “I appreciate you!”

11.08.17

a good day for america

Posted in Uncategorized at 7:36 pm by Administrator

danica roem and andrea jenkins, i salute you.

i’ve been telling my wife for the last six months that i believe an impeachment of donald trump would be a really unfortunate thing for america. he needs to serve the full term and do the maximal possible damage to his party and to the conservative cause. it’s all working out as i suggested almost a year ago: trump is galvanizing those who hate him, and this is facilitating progressivism in a manner that would have otherwise been inconceivable. a transgender woman was elected to the Virginia legislature yesterday. i never imagined i would see the day. the fact that her opponent ran and lost on a podium of questioning her basic integrity as a transgender person just makes the victory that much more salient—because it reflects cultural change, not merely political expediency.

on many things that obama simply failed to deliver on, trump is sealing the deal. while embarrassing america on the international stage, he’s crucifying conservatism at home. he is, in brief, the best thing that has happened to the American Left in decades.

in an odd kind of way, i’m understanding through trump’s presidency a biblical truth that perhaps eluded me for a long time. there is a societal purpose for those who reject Christ, as there is a purpose for those who are elected for the kingdom. the societal purpose of the heathen is to demonstrate through their lives the human necessity for God by illuminating what is painfully lacking without him. in the same way, the purpose of donald trump is to demonstrate through his failed presidency a compelling political necessity for intelligent, compassionate, and visionary leadership.

so, as i salute danica roem today, i salute you as well, donald. you are the champion of a cause you do not believe in, and because of you, the country is changing for the better.

11.01.17

halloween is what christmas ought to be; the book of dust; and sports

Posted in Uncategorized at 6:59 pm by Administrator

i never particularly enjoyed halloween when i was growing up, mostly because my parents never put much effort into equipping me for a pleasant experience. i always had the worst costumes in elementary school. i was always embarrassed when i showed up at school with something i’d put together on my own. when i was in the fifth grade, i literally cut holes out of a paper plate and taped it to my face; that was my fucking costume. unfucking believable. don’t do that to your kids, ever. take halloween seriously and help them buy a goddamn costume that they won’t be utterly mortified to wear.

despite hating halloween as a child, and despite invariably shutting off the porch lights every year on halloween so that people know not to drop by, i have come to appreciate halloween for the very special holiday that it is. on what other day of the year do people actually open their doors to strangers and give them free goodies? what other time of year do members of a community openly show affection to one another to this degree? and when else do we have such license to put on clothes and makeup purely for the purpose of entertaining and amusing others around us? in a sense, though we wear masks and outfits that disguise us, we are tapping into something on halloween that is uniquely ourselves; we are challenging social boundaries that ordinarily compel us to conform to a strict code of dress and conduct.

in my interpretation of the gospel, it was for something like this that Christ came to earth and died for humanity. he came to liberate us from onerous social mores, so that we might exercise this liberty through unabashed and loving service to others, including strangers and even enemies. i find it ironic that when christmas comes around, we commemorate Christ by closing our doors, huddling with our own families, and spending lots of money on material things intended to fill the emptiness of our lives and to substitute for authentic expressions of love. if Christ walked among us, i think he’d strongly prefer Halloween to Christmas. he’d go trick-or-treating just to meet people and their children and enjoy that honest, unusual, and cathartic communal connection; and chances are, He’d be the trickster and not the treater, with all his damn parables and confusing stories about Himself. sometimes Christ of the Bible truly pisses me off, but that’s another story for another time.

i’ve been waiting fifteen years for Philip Pullman’s sequel to the Golden Compass trilogy, and the “Book of Dust” trilogy has officially kicked off with “The Belle Sauvage”. i’m not going to spoil it here, but i think i’ll say two things about my experience of the story: it was a page-turner, and i’m looking forward to the next book. i was surprised by how mundane and actually unimaginative this first book was, but i’m not going to complain until i see where the story is going in the subsequent books. pullman remains in his element with biting critiques of the church, terrific characters, deftly written prose, and a knack for depicting serendipitous romance, and i’m hopeful that he takes Dust to the heart-wrenching and groundbreaking place where Amber Spyglass left us.

i’m not a dodger fan, and i wasn’t really engaged in this series until yuli gurriel embarrassed himself and his countrymen on national television with the “slant-eye” gesture aimed at denigrating L.A.’s half-Japanese pitcher Yu Darvish. now i really want the Astros to lose, because gurriel is a motherfucking disgrace to the sport. my reaction reflects two things: 1) i get pretty emotional about racism, and 2) i think it’s fair to judge a team and its fans by the actions of one player. houston fans gave gurriel applause and support after his 2018 suspension was announced. that’s plain stupid. houston fans, check yourselves. you deserve sympathy for what you just went through—but don’t pretend like this racist gesture is just part of the game. i would hope that i’m never so blinded by my love for a team, organization, or country that i’ll excuse something like this.

i’m tempted to go a bit further here and speculate on the root causes for gurriel’s basic ignorance and racism without any real knowledge of who he is as a person. but that would be racist of me. i know some good cuban people; i know plenty of Latinos who’d never do such a thing. so my conclusion here is that yuli gurriel is an idiot who happens to be a baseball player from the island of cuba. if i ever see him, i’ll have to think about whether or not to spit in his face. i probably won’t do it, because by that point i probably won’t be emotional about this anymore.

one thing i feel i should be more emotional about is the Eagles season. it’s not that i don’t believe in their success or their prospects. it’s that i just don’t really like the team. there are certainly players that i like and respect a great deal: carson wentz, darren sproles, jordan hicks, and malcolm jenkins to name a few. but a lot of our team members are brand-new, and it feels like a group of guys that we bought with money and threw into the mix for wins. when you take into account stability and chemistry, the team has more identity on the defensive side, but even there without jordan hicks and without any consistent play in the secondary, i struggle to feel confidence in what we’re doing out there. on the offensive side, i feel that we’re just riding a wave of excellence in wentz’s play, but we don’t have a running game to lean on, and our offensive line even when we had jason peters was partly to blame for that.

we’re going to make playoffs, but i don’t think we’re going to go very far. if mychal kendricks suddenly turns into a good linebacker and ronald darby magically makes a leap in the second half of the season, then we might be a team that can push through the expected inconsistencies on offense and tough out those close, intense games we’re sure to have in the NFC bracket. but one thing’s for sure: carson wentz’s early-season brilliance isn’t sufficient to get us where we need to go, and that’s why i’m on the sidelines frowning and shaking my head a little. 7-1 is like a dream… when are we going to get the rude awakening?