A Reading and Reflection for Advent

"They shall beat their swords into plowshares, and their spears into pruning hooks; nation shall not lift up sword against nation, neither shall they learn war any more. O house of Jacob, come, let us walk in the light of the Lord!"

-Isaiah 2:4b-5

As we bumped along the deeply-rutted Tanzanian road, we passed a man pushing a bicycle loaded with an enormous bale of corn stalks. I could not help but admire the seemingly impossible balancing act on his bike. I watched until he disappeared into the cloud of dust kicked up behind our truck.

Tanzanians "re-purpose" just about everything. Old tires turn into sandals. Containers become walls of homes. Five-gallon plastic chemical buckets haul water and food. Any object that is no longer needed for its original purpose is refashioned into something useful.

Isaiah tells of a time when weapons of war will become implements of agriculture. I always viewed this as idealistic, futuristic imagery of a world living in peace. Perhaps the man with the packhorse-bicycle would regard this passage differently. He might imagine himself choosing several shiny steel swords, pounding and shaping them into plow blades, and then fixing them tightly to a frame to be pulled behind an ox. Where I see romantic platitudes, he sees practical challenges.

Our Tanzanian friends certainly view the world differently than we do. Each of us, however, hopes that Advent will "re-purpose" our lives. Pray that we see this as a real, tangible opportunity and not just as a far-away dream.

God of the mountain and of the suburb: Prod us out of the hiding places to which we have retreated and force us to expand both our boundaries and our imaginations. Re-purpose our lives right now as we care for Your truly remarkable world, and inspire us to build relationships of peace and justice. In Your holy name, we pray: Amen.

Prepared for St. John's Lutheran Church, Brookfield WI

Milestones

I am old enough (barely) to remember November 22, 1963. Back in those days, before working mothers, school lunchrooms, and buses, we all walked home long enough to have a sandwich and a bowl of soup before walking back to school for the afternoon. I was sitting in front of the black and white television and watching Bozo’s Circus when a serious (male) voice cut into the show.

“We interrupt this programing to bring you an important bulletin.”

I remember being afraid and confused. I recall pictures of adults crying. I stared at pictures in Life Magazine of the funeral procession with the riderless horse. I know that I was terrified for years every time a program was interrupted.

A whole generation of us knew exactly where we were and what we were doing the moment we heard of Mr. Kennedy’s assassination. It tied us together and started conversations. For better or worse, it gave us all a common moment in time – a touchstone – that could blend our experiences into one.

For decades, few other moments came close to a creating a moment which was so universally overwhelming. I was working on a project in a research laboratory at MD Anderson Cancer Center the morning the space shuttle Challenger exploded in 1986. Perhaps the experience was intensified because we were living in Houston at the time, and the television stations had many  opportunities to explore local angles. Despite the passage of 23 years since that day in 1963, the sadness rolled over us as it had so long ago.

On September 11, 2001, I was performing surgery when one of the anesthesiologists popped into the room to tell us that the first tower had been hit by a plane. A few minutes later, he returned to tell us about the second plane and, not long after that, he brought news about the attack on the Pentagon. I begged him to stop. I needed to concentrate on my patient and his surgery. The sense of shared grief, which would certainly come, just had to wait.

Just wondering...

So, if you are certain that God loves you more than God loves me, does that make you a gracist?

Palliative Grand Round is Up at Pallimed

The inaugural edition of Palliative Care Grand Rounds is up at Pallimed. Christian Sinclair has compiled a remarkable assortment of posts by palliative care workers, patients, and family members. Rounds will be posted monthly.

For those of us who are from outside of the Palliative Care world, these posts provide a fascinating look behind the curtain.

Pass the word!

Writing but Not Posting

Our electronic medical record is great! No, really, I mean it. I love the clarity it provides and I love having all of my colleagues' notes available. Since I am spending my evenings preparing my own progress notes, the turn-around time from appointment to outgoing letter is only a couple of days! That is what the system is supposed to do.

Still...

As the new system takes over my life, I find that I am writing less, journal-writing less, emailing less. I guess I get only so many keystrokes in my day before my fingers say, "Enough!" For example, one of my New Patient Consultation notes this week was 1100 words. That's enough for a couple of blog posts.

So, if blog volume is slowing down, maybe it is because my keyboarding duties are picking up. As the medical record transition settles down, I hope my writing returns to the more creative.

One-Trick Pony

Every once in a while, I get interviewed. Yesterday, it happened once again.

About noon on Wednesday, just as I was finishing seeing patients in clinic, I received a call that a local TV station wanted a doctor to talk about the dangers of cancer patients continuing to smoke.

"Why are they interested in that right now?" I wanted to know.

"Patrick Swayze is being interviewed by Barbara Walters tonight on ABC. He is still smoking and has no intention of giving it up. Can you talk to them?"

"Sure," I said. We made arrangements. A couple of hours later, I spent 10 minutes talking about several aspects of the problem: How patients who quit have better survival statistics, how quitting decreases rates of second primary tumors, how quitting saves money, how quitting improves quality of life, how reassuring quitting can be to family and friends. It was a nice discussion. As ususal, only about 10 seconds of the conversation made it on the air.

I reflected on the experience. First of all, the process of giving an interview is fun. I enjoy the chance to appear on TV in the same way I enjoy the blog: it gives me the opportunity to reflect on what I see every day and distill my thoughts into a few words.

On the other hand, I realized that every time I have been on TV or get quoted in the paper, I become the dreary voice of authority: Smoking is Bad. Cancer is Bad. Research is Good. Snuff is Dangerous. Cigars are Not A Safe Alternative.

Not the stuff of comedy, irony, or light conversation.

I still got a kick out of seeing myself on TV last night and am amazed how many people spotted my brief moment on the air. Someday, though, it would be fun to talk about something a little less - say - predictable.

2008 Medical Weblog Award Finalists Announced

My other blog (Reflections in a Head Mirror) is a finalist for the 2008 Medical Weblog Award in the "Best Literary Medical Weblog" category! Thanks so much to previous winner Ramona for the nomination. I have really enjoyed visiting the other sites on the list. There are some truly amazing stories and gifted writers represented.

If you are interested, voting will take place for the next couple of weeks at the links found here.

It's an honor to be included in a list like this! May the best blogs win!

Best Medical Weblog
Clinical Cases and Images
Clinical Correlations
The Health Care Blog
Kevin, M.D.
WSJ Health Blog

Best New Medical Weblog (established in 2008)
Laika's MedLibLog
Life in the Fast Lane
medtechinsider
The New Health Dialogue
Science-Based Medicine

Best Literary Medical Weblog
Notes of an Anesthesioboist
On The Clock
other things amanzi
Reflections by Dr. Bruce Campbell
Running for My Life: Fighting cancer one step at a time

Best Clinical Sciences Weblog
Clinical Cases and Images
Clinical Correlations
scan man's notes

Best Health Policies/Ethics Weblog
Better Health
The Last Psychiatrist
Stuart Laidlaw's Medical Ethics blog
Medical Futility
Respectful Insolence

Best Medical Technologies/Informatics Weblog
AppleQuack
Clinical Cases and Images
Life as a Healthcare CIO
medtechinsider
Ted Eytan, MD
TomographyBlog

Best Patient's Blog
Alin's Site
Beating Social Anxiety
Brass and Ivory: Life with Multiple Sclerosis
ButYouDontLookSick
Confessions Of A CF Husband
Duncan Cross
Furious Seasons
Look Me In The Eye
Running for My Life: Fighting cancer one step at a time
Six Until Me
Soulful Sepulcher
Survive the Journey