Monthly Archives: March 2013

Trust Fall Fail

I’m guessing the older sister is going to have some trust issues.

Having faith is hard, isn’t it? I heard a sermon by Philip De Courcy on the radio talking about the story of the prophet Elijah and the widow in 1 Kings 17:7-16. There was a severe drought and God told Elijah that a certain woman was going to provide for him. So off he went and found this woman out gathering sticks. He asked for some water and bread, but apparently the widow was on the verge of starving to death, having just enough for one last meal for her and her son. I guess God didn’t give the widow a heads up.

Verses 13 and 14 are quite astonishing given the woman’s predicament: “Elijah said to her, ‘Don’t be afraid. Go home and do as you have said. But first make a small cake of bread for me from what you have and bring it to me, and then make something for yourself and your son. For this is what the Lord, the God of Israel, says: ‘The jar of flour will not be used up and the jug of oil will not run dry until the day of the Lord gives rain on the land.'” (emphasis mine)

Imagine being one meal away from watching your child die from starvation and encountering a stranger who asks for you to make him something first out of the very little you have left, and promising some magical unlimited flour and oil. Why don’t I make some bread for me and my son first and see if the flour and oil will keep on coming?

Isn’t that what goes on in our minds when God asks us to step out in faith and trust Him? Perhaps God is asking us to wait on Him to start a relationship. Or asking us to step out in faith to take a less prestigious or lower paying position. Or even to reach out to someone who is difficult to love. But stepping out into the unknown is hard. We want the whole thing laid out first, and especially the outcome before we’ll say yes to God.

Funny thing is that God has already laid it out for us. I hate to spoil the Bible mini-series but we know how it ends. Christ will return in glory and God’s kingdom will be ushered in full. On that day, we will realize that the things we gave up in faith for God really wasn’t much at all compared to all that God has in store for His children.

And how do we know that God will do exactly as He promised in the Bible? Well, as Easter sunday is just a few days away, the resurrection of Christ showed that God was faithful to His promises then, and it gives us confidence that God will be faithful to His promises today. So as we celebrate Resurrection Sunday, let us be reminded that our God who is soverign over history is also sovereign in our everyday lives. Sometimes God only shows us enough to take the next step. But look far down and take heart that God has taken care of the end.

How is God asking you to trust Him today? 

“She went away and did as Elijah had told her. So there was food every day for Elijah and for the woman and her family. For the jar of flour was not used up and the jug of oil did not run dry, in keeping with the word of the Lord spoken by Elijah.” 1 Kings 17:15-16

Thanks Priscilla for the clip!

 

How to Cope

In my last post I talked about how difficult it is for those in medicine to repeatedly come face to face with human suffering. Whether it was the consequences of personal choices or due to unfortunate circumstances, the burden of caring for the sick can weigh heavily on the soul. It’s sad that even though medical training strives to raise up compassionate healers, people often come out jaded and cynical instead. Here are just a few things that have helped (and continue to help) me on the way.

1. Take a time-out

Medical training is such a hectic process, especially during your intern year. There is just so much to do you’ll be running around like a chicken with its head chopped off, rushing from floor to floor, patient room to patient room. Sometimes you just need to mentally check out for a moment. There was this place outside the hospital I would go to from time to time just to re-group. Even if you can’t escape the clinic or hospital, pausing for a minute before seeing the next patient can help to let your emotions catch up to your body so that you can be fully present.

2. Learn your patients’ names

It’s amazing how there are days I can’t remember a single name of the patients I saw that day. This might seem counter-intuitive, that the more you get to know a patient, the harder it will be emotionally  if things take a turn for the worse. But I think it is the dehumanizing of our patients that makes our jobs seem pointless and futile. Our patients become just another thing to fix, another obstacle asking of us our energy and time that is already so limited. But connecting with patients as people can help us celebrate with them the small victories even if there’s no ultimate cure.

3. Journal

Our experiences are meant to be processed, not buried away. I started my book project wanting to be helpful to others. After I finished writing, I found that there was something hugely therapeutic in revisiting my training experience and working through the lessons that I learned. If no one buys or reads the book, it would have played an important role in helping me articulate one of the hardest seasons of my life. You don’t need to write a book, but who knows, maybe one day your ramblings can turn into one.

4. Connect with others

This is along the lines of number 3. Medical school and residency were my loneliest times, even though their were plenty of people around. It’s hard to talk to others about our experiences because either we don’t want to be a burden, or we don’t think others will understand. The problem is that we are created as relational beings, so we do need others to help us process. Don’t forget your relationships, particularly your spouse. And sometimes professional help might be necessary. There’s no shame in this; some of the situations you’ll face will be intensely traumatic. There are resources available through your program so don’t be afraid to seek those out.

5. Keep the eternal perspective.

As high a calling it is to care for people’s physical body, we have to be reminded that there is a higher, spiritual reality. In the words of Dr. Cox from Scrubs, “Sooner or later, you’re going to realize that everything we do around here, everything is a stall. We’re just trying to keep the game going, that’s all. But, ultimately, it always ends up the same way.” The decay of our bodies and eventual death is inevitable, and while our job is to hold back the tide, our job as Christian physicians is, through our care of the physical, to point people to a deeper spiritual healing that we all need. This is where we need to remember God’s promises that He will one day make all things new.

This is just a short list of things I found helpful that I am still learning to do as I continue in my career as a physician. The road is a difficult one. My prayers go out to those who have embarked on this journey.

What has helped you from developing cynicism and becoming jaded?

 

 

 

 

Why God Doesn’t Just Heal Everyone

One of the most difficult things for me is seeing all the sick people in the hospital and wondering why God doesn’t cure people anymore. It’s tough.

This is a recent comment I got from a medical student. Thanks for your honesty, it certainly is tough. For me, it was especially tough seeing kids with terrible diseases. I remember being present at the still-born deliveries of twins and thinking, “God, how can you let stuff like this happen?” The question I was really asking was, “God, if you are good, why do you allow suffering to happen?” The follow-up to that question is, “God, if you are good and all-powerful, why don’t you do something about it?”

This is a hard one. I think the best answer I’ve heard was from a sermon by John Piper who said that suffering and tragedies ought to remind us of our initial rebellion against God.  It is a reminder that the world as it is was not the way it was created, but what we see now are consequences of our sin against God. I mentioned this in a previous post that because of Adam and Eve’s sin, not only was our relationship with God broken, but the whole natural order was corrupted (Romans 8:19-21).  That means diseases (as well as natural disasters) are as much a result of sin as all the terrible things that people do to one another.

But knowing that suffering is ultimately the result of our separation from God, while true, isn’t very helpful when we come face-to-face with the ugly realities of this world.  We can kill ourselves asking the why’s but, often times, God doesn’t give us the answers.  Instead He says, “Look to my Son.”

I don’t think we’ll ever figure that out why God created the world knowing all the suffering that was going to result. But, somehow because of His love, it was worth it to create despite knowing that we would fall into sin.  But God didn’t just create and run away.  No, God was here. God entered into this world of suffering and sin in the person of Jesus, the incarnate Son.

When Jesus came into this world, yes He did heal the sick and make the lame walk.  He even raised the dead.  But there were multitudes that were not healed and even more who remained dead.  God was here at one time, but He was not here to end all suffering.  God was here, shared in our brokenness and suffering, and died on the cross to meet our ultimate need: to be reconciled with our creator God. Jesus’ healings and other miracles merely backed up His divinity and His ability to forgive our sins.

The story doesn’t end there. Not only was God here, but God is also near: Jesus is going to return.  While He didn’t come the first time to end all sickness, poverty and natural disasters, when He returns, that’s exactly what He will do.

I don’t want to minimize the sufferings we encounter because the pain we experience is real. We should care. God cares. While we may be angry with God, without God there is no good answer for the problem of suffering. Without God, tragedies ultimately have no meaning; they just happen. But we have a God who took on the ultimate suffering, bearing the burden of our sins on the cross.

So back to the question, why doesn’t God just cure everyone?  He actually still does heal (worthwhile read), but miraculous healings are the exception rather than the rule because there’s a spiritual reality that our sufferings point us to. More often, God uses ordinary people to be his hands and feet in order to love someone in their time of suffering to help them see their ultimate need for God, pointing them to Christ.

For future healers, this is not an easy calling to battle against the consequences of sin. In my next post I’ll write about some ways to process through these difficult experiences. For starters, let us remember the words of Revelation 21:4-5 that one day God “will wipe every tear from their eyes.  There will be no more death or mourning or crying or pain, for the old order of things has passed away.  He who was seated on the throne said, ‘I am making everything new!’  Then he said, ‘Write this down, for these words are trustworthy and true.’” 

For those of you in the medical field (or any field for that matter), how do you deal with the suffering that you see? Please feel free to comment.

Adapted from a previous post in response to the Sandy Hook shooting

3/30/13 Found this video that has some good insights

 

 

Medical Training Advice: How to Prepare for Residency

Congratulations to all who matched into residency! For those who don’t know, last Friday was Match Day where everyone who got accepted into a residency program found out where. During your fourth year of medical school, you apply to residency programs in your field of interest. After your interviews (hopefully you get some), you then submit a list of the programs in order of preference. The residency programs also rank all the students they would like to accept and by some magical (and complicated) formula, you are “matched” with a residency program based on the respective rankings.

Where you match is where you have to go, unless you decide to take the year off and try again the next year. It’s a bit of a lottery so it’s quite nerve wrecking. During match day there’s usually some sort of ceremony where all the envelopes with the match results are laid out with your name on it and it’s a royal rumble affair to get your envelope. Some schools have students individually come up to get their results (extra torture). Usually there’s a lot of rejoicing, but there’s also disappointment for those who don’t get their top choices. But regardless of where you match, it’s a huge achievement so my congratulations again.

People ask what they should study or if they should do really hard rotations near the end of medical school in order to prepare for residency. To that, I reply with a resounding NO. There definitely is preparation to do, but not in medical knowledge. That’s what the 1st three and a half years of medical school was for. Medical school is hard, no doubt about it. Residency, though, is on a whole other level. You need to establish and re-establish some life-lines.

What are life-lines? These are the things most important to you that renew you, encourage you, and support you. These are things that will give you the strength to get up again after being beat-down, sleep deprived, and emotionally trashed, and do it again and again. These are probably things you have neglected because of all the studying and rotations during 3rd year. First and foremost are your relationships.

The most important is your relationship with God, and it really is time to reconnect with Him and build into your routine the basic spiritual disciplines. If you didn’t have time during medical school to read your Bible and pray, then anticipate not having much of a relationship with God in residency. You have to be very intentional about carving time out for God, and if you are in the habit of doing that when you do have time, you’ll build up the discipline to do that when life gets busy.

Now is a good time to start scoping out churches where you will be training. Hopefully you took into consideration the church community in your ranking process. If you don’t have a church home, it might be a good idea to find a church with different services so that you can go if you are on call on Sundays or post-call. Fellowship with God and other believers is going to be key in reviving your soul and reminding you of why God called you into medicine.

Next is your relationship with your significant other, especially your spouse. They will be your number one fan, but they also will be affected by the difficulties of residency. The long hours and the emotional drain will cause big strains so it’d be wise to strengthen your marriage prior and continue to tend to your relationships during the process. This is a huge topic just by itself, you can read this article for more on the subject. Of course your relationship with your family and friends are important so make an effort to build up your encouragement base before the craziness starts. You’ll need all the support you can get.

Lastly, I’ll just mention you need to connect again with the activities that give you joy, whether it’s a sport, hobby, or special routines. Medicine isn’t just about caring for others, you have to care for yourself first. Again, residency will be hard. There will be times when you can’t do all that you want to do (or know you should do). Hopefully by building up the support and habits now, you can not just survive residency, but thrive.

What are your life-lines?

 

 

Open Door Policy

As a family physician doing primary care, some days are a real joy. Patients are those that I have seen before, they have taken their medications like they are supposed to, and what I did actually helped. Throw in a couple of baby visits and I go home with a smile on my face.

Then there are those days where all the stars align, in a bad way. The patients come in with their list of complaints and nothing that I have tried has had any effect at all. Some are demanding, others are just as frustrated because we can’t figure out what is going on. By the end of those clinic days I can’t even blog about what I’m thinking in my head.

I read this passage recently: ‘That evening after sunset the people brought to Jesus all the sick and demon-possessed. The whole town gathered at the door, and Jesus healed many who had various diseases.” Mark 1:32-34

It never ceases to amaze me to read about how Jesus received those who came to him for help. And those going to him weren’t well-to-do nice people, but the prostitutes, demon-possessed, lepers, and tax collectors. It should serve as a warning that those who recognized the truth about Jesus were not the religious elite whose lives appeared put together. No, it was the outcasts and those shunned by society who saw the hope of Christ, and subsequently experienced His compassion and love.

Sometimes it is hard to love, especially if you are expected to meet needs over and over again. And over and over again, I find myself falling short of God’s command to love as Christ loved us. But, I forget that Jesus also needed to spent time alone with His Father. After that night of healing the entire town, the very next verse in Mark says, “Very early in the morning, while it was still dark, Jesus got up, left the house and went off to a solitary place, where he prayed.”

I keep asking God to help me grow in my love for others, to love like Jesus loves. Maybe God’s been telling me, “Come, experience my love first, again and again.”

How have you experienced God’s love recently?

(thanks Rich for the post idea!)

My Most Embarrassing Moment… and it was caught on video

Don’t try this at home. If you do, wear a jockstrap.

It never ceases to amaze me how this happened. It could have been worse. A LOT worse. Suffice to say that I never did that jump ever again, and it took awhile for me to try anything new on the slopes.

It’s incredible how paralyzing our fears can be, and for me, especially my fears of embarrassment and failure. These fears have caused me to live mostly in my comfort zone and avoid the things that I might potentially fail at. Unfortunately, in my Christian life that translates to simply living life on my own strength without much of a dependence on God.

Many times the things God calls us to are not within our comfort zones. A recent guest speaker, Todd Grant, challenged us with this: “God’s holy calling are hard callings, if its not hard it’s probably not Him.” Some of my recent career decisions have been difficult (and scary). Stepping out in faith with this book project and blog has been hard. Jesus did promise that those who follow him will be ridiculed and rejected by the world, just as the world rejected Him. But I have this promise from Romans 9:33: “See, I lay in Zion a stone that causes people to stumble and a rock that makes them fall, and the one who believes in him will never be put to shame.”

I may very well “fail” in the eyes of the world. But if anyone ever asks, “Have you ever tried a snowboarding jump but slipped at the last minute, falling in such a way over a fire hydrant to avoid massive internal damage but getting stuck in the process while crowds watched and laughed at me?” I can say, yes I have. And I have the video to prove it.

What has God called you that you have not yet embraced because of your fears? How does our relationship with Christ help us with those fears?

The culprit that caught this on video: Jeff Wu

 

Sermon Feedback/Discussion – Discipleship Living in Action

Hi church family!

Again I would like to invite you to interact with the sermon this past Sunday as well as give you an opportunity to provide feedback or ask questions. I would even love to just hear how you were challenged by the sermon. If you would like the written transcript, message me and I can send it to you.

Note that if you leave a comment, it will be visible to anyone who visits so if you want to share something just with me, go ahead an email me at jacktsai@unfailingspring.com. I really want to hear from you!

Sermon Recap: Luke 16:1-13 Discipleship Living in Action

Disciples of Christ have an allegiance solely to Christ and live for kingdom purposes.

Jesus gives an example of this type of single-minded living in the parable of the shrewd manager.

The manager is commended for acting shrewdly in giving discounts to his master’s debtors, at the cost of his master.

Jesus is commending not the immoral action, but the manager’s mindset. The manager knows judgment is coming and so he does everything he can to maximize his future well-being with the remaining time and influence he has as the manager.

In the same way, judgment is coming for all and we will have to give an account for all that we have been given. Jesus’ exhortation here is that we would spend our remaining time, using to the max all that we have been given, in such a way to further God’s kingdom plan, ensuring our entrance into heaven.

Application: We are to use our worldly wealth*, our abilities, and our influence strategically and intentionally to further God’s kingdom.

*Note: The passage is mostly about how we handle worldly wealth, and in particular carrying out God’s heart by using wealth for the service of those less fortunate. Since we have talked a lot about our use of money in previous sermons, I focused more on the application of using our abilities and influence to maximize God’s kingdom.

If you missed the sermon (we missed you!) and would like to listen to it, you can look it up on our podcast below for free. It is usually uploaded within a few days.

SBECC Kairo English Ministry Podcast

Super Important Message to Read!

Since I’ve been working on the book project, I’m learning a lot about marketing and building a following in order to actually get my message out. Currently I am reading Platform, a book by Michael Hyatt about this very topic. With the revolution of social networking, it definitely takes some intentional strategizing to get people to care about what I have to say amidst all the noise, distractions, and desperate sounding blog post headlines.

I’ve never felt older and behind the times trying to jump onto the social network bandwagon. I now have a twitter account and learned what a hashtag is and what RT stands for; I’m making progress. And along with revamping this weblog and trying to get it going, this has all taken quite a bit of time. All because of this book I am writing and the message that I want to get out.

It dawned on me (largely with the help of my wife) that as a Christ follower, I have had a message to get out for quite some time now. But, I probably spent more time this past month thinking about how to promote my book than I have over the last years thinking about how to share the Gospel in a way that will reach the most people.

Priscilla, thank you for reminding me the reason that I am doing all of this. Not for my own glory, not to spread my message, but ultimately to point people to God and the saving message of the Gospel. Christians, let’s redirect the energy that we are putting into planning and scheming for a better college, job, deal, more twitter followers, or whatever else and invest it into strategically advancing God’s kingdom. Knowing that we will one day be held accountable by God, how can we use all that we have been given to maximize God’s kingdom purposes? If interested, I’ll be preaching on this tomorrow at SBECC!

21 To those not having the law I became like one not having the law (though I am not free from God’s law but am under Christ’s law), so as to win those not having the law. 22 To the weak I became weak, to win the weak. I have become all things to all people so that by all possible means I might save some. 23 I do all this for the sake of the gospel, that I may share in its blessings. 1 Corinthians 9:21-23

*I transferred my wordpress.com site to my own hosted website so it canceled all those who have subscribed. If you would like to continue receiving my posts, please subscribe again!  I apologize for the inconvenience :(*

Super Resistent Bacteria!

The CDC put out this advisory warning against a rise in carbapenem-resistant enterobacter, or CRE. This is basically a bacteria that has developed a resistance to carbapenem, one of the “big-guns” antibiotics that we reserve for when all the other antibiotics fail. And apparently, there are bacteria that are becoming resistant to these too.

In the 1920s Alexander Fleming discovered penicillin, which would later win him a Nobel Prize because it changed the medical and pharmaceutical world. This discovery made possible the development of antibiotics to treat bacterial diseases. Innumerable lives have been saved because of these medications.

There are now many classes of antibiotics to treat the different bacterial strains that exist, with varying degrees of effectiveness. Researchers are working hard developing new antibiotics because, unfortunately, the bacteria has found a way to survive. Each antibiotic class targets a specific mechanism that the bacteria uses, i.e., to reproduce, infect, etc, and one fortunate mutation (from the view of the bacteria) can render an entire class of antibiotics useless for that organism. This is called developing resistance.

As a result of widespread use of antibiotics, often inappropriately to treat common viral illnesses, there are now many strains of highly resistant bacteria. In addition to MRSA, ESBL, and VRE (other resistant bacterial strains), I can now add CRE to the list of scary things I never want to get (except I’m pretty sure I am colonized with the 1st three from working in the hospital). According to the article, “one report cites they can contribute to death in up to 50% of patients who become infected.” Uh yeah…be careful my hospital-dwelling friends.

This is probably how the zombie apocalypse is going to start with eventually a super mutant bacteria emerging that is so powerful that it not only kills, but reanimates the body afterwards. It’s crazy that despite how smart we are and the fancy technology we develop, the effects of sin will continue to decay the natural order. The Bible tells us that our initial rebellion against God not only affected our relationship with Him, but corrupted the very fabric of creation.

Whereas we were created to be in intimate fellowship with God and others, charged to rule over creation, because of sin now we live alienated from God, in conflict with one another, and at the mercy of the elements. Jesus came to usher in God’s kingdom, to bring us back to how creation was intended before the Fall. We, as believers, are charged to carry on God’s work of restoration through whatever gift God has given us as we live on this earth, awaiting for the process to be completed when Christ returns. What part has God called you to play in His redeeming work?

18 I consider that our present sufferings are not worth comparing with the glory that will be revealed in us. 19 For the creation waits in eager expectation for the children of God to be revealed. 20 For the creation was subjected to frustration, not by its own choice, but by the will of the one who subjected it, in hope 21 that the creation itself will be liberated from its bondage to decay and brought into the freedom and glory of the children of God. Romans 8:18-21

HIV Cure??

Read this on the news recently about a baby cured of HIV through early and aggressive antiretroviral meds. This would be the second documented case of a patient cured from HIV. No, the first was not Magic Johnson. It was this guy.

This reminded me of an illustration I used in a sermon some time ago. It’s pretty incredible the medical breakthroughs that have come out of HIV research over the years, and particularly in the realm of pharmaceuticals. Where it used to be a death sentence not even that long ago, HIV is now like a chronic disease that can be controlled with medications.

Yet despite all the medical advances and even though this story is exciting, there is no definitive cure. HIV is still a huge problem, especially overseas. HIV is such a fascinating virus the way it hijacks the body’s own cells to replicate itself, destroying the host cells in the process. Usually when something like that happens, our immune system catches on and starts to destroy the infected cells. But with HIV, the cells it takes over are the very ones that participate in the immune response. As the virus spreads, our body’s natural defenses fall apart, and eventually what kills the patient are other infections and diseases that take advantage of the weakened immune system.

HIV kills indirectly by getting rid of the very cells that are able to distinguish between what is good and what is bad. How devious. Satan also uses a similar strategy, doesn’t he? As Christians, we believe that the Bible teaches us the standards of truth, what is right and what is wrong, what is good and what is evil. Satan knows that to weaken the church, you must destroy the truth on which the church stands.The New Testament writers spent a good amount of energy combating false teaching from spreading within the church. If you blur the lines between right and wrong, then people will eventually destroy themselves by indulging freely their desires.

Those warnings written 2000-plus years ago are still so relevant for us today. Looking at our post-modern world, I would say Satan has done an awfully good job. For many, there is no more objective truth and what’s wrong might be completely right to another. This moral relativism denies that the Bible has authority to proclaim what is right and what is wrong, and as a result people can live however they please. And in our apparent pursuit for freedom, we end up enslaved to our passions instead.

Let’s guard the truth with the same fervor as the Biblical writers. We need to know the Word so that we will not be deceived by the schemes of the evil one. What are some good ways you have found to be in the Word more consistently?

13 What you heard from me, keep as the pattern of sound teaching, with faith and love in Christ Jesus. 14 Guard the good deposit that was entrusted to you—guard it with the help of the Holy Spirit who lives in us. 2 Timothy 1:13-14